Provider Demographics
NPI:1831536986
Name:ALICIE, JAIME LYNETTE (STNA)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LYNETTE
Last Name:ALICIE
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:MRS
Other - First Name:JAIME
Other - Middle Name:LYNETTE
Other - Last Name:PAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:STNA
Mailing Address - Street 1:859 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-4348
Mailing Address - Country:US
Mailing Address - Phone:740-244-6273
Mailing Address - Fax:
Practice Address - Street 1:859 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4348
Practice Address - Country:US
Practice Address - Phone:740-244-6273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4012261804113747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant