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General NPI Number Information
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NPI Number | 1689157570
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Entity Type | Individual
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Provider Name | JENNIFER JOY DOUGLAS LPN
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Gender | Female
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Dates
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Enumeration Date | 09/07/2018
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 935 PYRAMID HILL BLVD APT 3B
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City | HAMILTON
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State | OH
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Zip | 45013-6420
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Country | US
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Telephone | 513-439-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 935 PYRAMID HILL BLVD APT 3B
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City | HAMILTON
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State | OH
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Zip | 45013-6420
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Country | US
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Telephone | 513-439-0300
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 82-1512550
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License Number State | OH
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