Healthcare Provider Details

I. General information

NPI: 1922902410
Provider Name (Legal Business Name): JAYNASHA KESHA MUNDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 S MAIN ST UNIT 302
AKRON OH
44308-1203
US

IV. Provider business mailing address

323 S MAIN ST UNIT 302
AKRON OH
44308-1203
US

V. Phone/Fax

Practice location:
  • Phone: 888-202-4232
  • Fax:
Mailing address:
  • Phone: 888-202-4232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.194757
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: