Healthcare Provider Details

I. General information

NPI: 1508910910
Provider Name (Legal Business Name): JAYNE ALLYSON VALERO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 ELDON AVE
COLUMBUS OH
43204-3703
US

IV. Provider business mailing address

72 ELDON AVE
COLUMBUS OH
43204-3703
US

V. Phone/Fax

Practice location:
  • Phone: 614-279-2571
  • Fax:
Mailing address:
  • Phone: 614-279-2571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN265827
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: