Provider Demographics
NPI:1881467298
Name:EANES, JAMEE LORRAINE
Entity type:Individual
Prefix:
First Name:JAMEE
Middle Name:LORRAINE
Last Name:EANES
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 1:640 S BURR OAK AVE
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-3448
Mailing Address - Country:US
Mailing Address - Phone:989-915-2177
Mailing Address - Fax:
Practice Address - Street 1:1702 S RIVER RD
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-5648
Practice Address - Country:US
Practice Address - Phone:608-756-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant