Healthcare Provider Details

I. General information

NPI: 1336923887
Provider Name (Legal Business Name): JAMIE LYNN MASON APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 PENTAGON BLVD STE 220
BEAVERCREEK OH
45431-1705
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 937-429-7350
  • Fax: 937-431-2623
Mailing address:
  • Phone: 513-502-4194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCNM07828
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN.CNM.0019555
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: