Healthcare Provider Details

I. General information

NPI: 1184750366
Provider Name (Legal Business Name): MS. JOCELYN MARIA MCDONALD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 09/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2236 MARCIA DR
COLUMBUS OH
43211-1946
US

IV. Provider business mailing address

2236 MARCIA DR
COLUMBUS OH
43211-1946
US

V. Phone/Fax

Practice location:
  • Phone: 614-478-5181
  • Fax: 614-478-8445
Mailing address:
  • Phone: 614-478-5181
  • Fax: 614-478-8445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: