Healthcare Provider Details

I. General information

NPI: 1083197123
Provider Name (Legal Business Name): JESSICA JAMBOR LISW-S, MSN-RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA ZAVELA

II. Dates (important events)

Enumeration Date: 09/14/2018
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3454 OAK ALLEY CT STE 214
TOLEDO OH
43606-1370
US

IV. Provider business mailing address

3454 OAK ALLEY CT STE 214
TOLEDO OH
43606-1370
US

V. Phone/Fax

Practice location:
  • Phone: 419-740-1836
  • Fax:
Mailing address:
  • Phone: 419-740-1836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.545984
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: