Healthcare Provider Details

I. General information

NPI: 1992344956
Provider Name (Legal Business Name): JAIME GAMIERE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2019
Last Update Date: 12/22/2019
Certification Date: 12/22/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12395 MCCRACKEN RD
GARFIELD HTS OH
44125-2967
US

IV. Provider business mailing address

1176 SUMMIT DR
MAYFIELD HTS OH
44124-1515
US

V. Phone/Fax

Practice location:
  • Phone: 216-587-6727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.448632
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: