Healthcare Provider Details

I. General information

NPI: 1790508679
Provider Name (Legal Business Name): JEWELL & KUDRO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 REDWOOD DR
CUYAHOGA FALLS OH
44223-3000
US

IV. Provider business mailing address

399 REDWOOD DR
CUYAHOGA FALLS OH
44223-3000
US

V. Phone/Fax

Practice location:
  • Phone: 330-631-7100
  • Fax:
Mailing address:
  • Phone: 330-631-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: JESSICA JEWELL
Title or Position: CO-FOUNDER
Credential: PHD
Phone: 330-631-7100