Healthcare Provider Details

I. General information

NPI: 1023960754
Provider Name (Legal Business Name): JAMILLAH LANAE SCURLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2057 W ALEXIS RD APT D5
TOLEDO OH
43613-5415
US

IV. Provider business mailing address

2057 W ALEXIS RD APT D5
TOLEDO OH
43613-5415
US

V. Phone/Fax

Practice location:
  • Phone: 419-936-4050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: