Provider Demographics
NPI:1659197739
Name:GARVER, JASMINE MIRANDA
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:MIRANDA
Last Name:GARVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10785 BLACHLEYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7416
Mailing Address - Country:US
Mailing Address - Phone:330-749-6979
Mailing Address - Fax:
Practice Address - Street 1:10785 BLACHLEYVILLE RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7416
Practice Address - Country:US
Practice Address - Phone:330-749-6979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-23
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide