Healthcare Provider Details

I. General information

NPI: 1528924347
Provider Name (Legal Business Name): JADA CLENDENIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2025
Last Update Date: 03/15/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 HILLS AND DALES RD NW
CANTON OH
44708-6220
US

IV. Provider business mailing address

PO BOX 80690
CANTON OH
44708-0690
US

V. Phone/Fax

Practice location:
  • Phone: 330-491-9675
  • Fax:
Mailing address:
  • Phone: 330-363-7444
  • Fax: 330-363-7770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.010147RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: