Provider Demographics
NPI:1801650254
Name:REED, JASMINE T (STNA)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:T
Last Name:REED
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:T
Other - Last Name:LATTIMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2150 AUGUSTA BLVD APT 118
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-8625
Mailing Address - Country:US
Mailing Address - Phone:513-499-6425
Mailing Address - Fax:
Practice Address - Street 1:2150 AUGUSTA BLVD APT 118
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-8625
Practice Address - Country:US
Practice Address - Phone:513-499-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH601340270421376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty