MEDICARE: JENNIFER LYNN SCHWAMB STNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	373595350194	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245211283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN SCHWAMB STNA

Provider Business Mailing Address
First Line	:	3959 JOHNSTOWN RD
Second Line	:
City	:	CENTERBURG
State	:	OH
Zip	:	43011-9428
Country	:	US
Telephone Number	:	740-625-6559
Fax Number	:

Provider Business Practice Location Address
First Line	:	3959 JOHNSTOWN RD
Second Line	:
City	:	CENTERBURG
State	:	OH
Zip	:	43011-9428
Country	:	US
Telephone Number	:	740-625-6559
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	07/09/2007

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