Healthcare Provider Details

I. General information

NPI: 1841043486
Provider Name (Legal Business Name): JAMIE N MATICS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 08/10/2024
Certification Date: 08/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 W BOWERY ST
AKRON OH
44308-1046
US

IV. Provider business mailing address

3991 PARK AVE
ROOTSTOWN OH
44272-9631
US

V. Phone/Fax

Practice location:
  • Phone: 330-983-7137
  • Fax:
Mailing address:
  • Phone: 330-983-7137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number447487
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number0037224
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: