Provider Demographics
NPI:1912051046
Name:ABRAMS, JERLENE S (RN)
Entity Type:Individual
Prefix:MRS
First Name:JERLENE
Middle Name:S
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 KRAMER RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-3311
Mailing Address - Country:US
Mailing Address - Phone:937-299-2298
Mailing Address - Fax:937-299-7558
Practice Address - Street 1:415 KRAMER RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45419-3311
Practice Address - Country:US
Practice Address - Phone:937-299-2298
Practice Address - Fax:937-299-7558
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 142866163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN142866OtherRN LICENSE
OH2604702OtherINDEPENDENT PROVIDER