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General NPI Number Information
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NPI Number | 1457994766
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Entity Type | Individual
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Provider Name | JESSICA MARIE PAPUGA LPN
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Gender | Female
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Dates
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Enumeration Date | 10/21/2019
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 174 MIDWAY BLVD STE 200
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City | ELYRIA
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State | OH
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Zip | 44035-2786
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Country | US
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Telephone | 440-723-8997
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Fax |
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Provider Business Mailing Address
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Address Line | 1317 ROUTE 73 STE 200
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-2202
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Country | US
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Telephone | 856-439-6111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN.146356.MEDS-IV
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License Number State | OH
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