Healthcare Provider Details

I. General information

NPI: 1548605876
Provider Name (Legal Business Name): HELEN F JABLONOWSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 NORTHLAND DR SUITE 200A
MEDINA OH
44256-3441
US

IV. Provider business mailing address

246 NORTHLAND DR SUITE 200A
MEDINA OH
44256-3441
US

V. Phone/Fax

Practice location:
  • Phone: 330-725-9195
  • Fax: 330-725-9187
Mailing address:
  • Phone: 330-725-9195
  • Fax: 330-725-9187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN093115
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: