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General NPI Number Information
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NPI Number | 1710590021
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Entity Type | Individual
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Provider Name | JASMINE MAYNARD
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Gender | Female
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 3200 BURNET AVE
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City | CINCINNATI
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State | OH
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Zip | 45229-3019
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Country | US
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Telephone | 304-785-1528
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Fax |
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Provider Business Mailing Address
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Address Line | 1517 SPRING VALLEY DR
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City | HUNTINGTON
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State | WV
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Zip | 25704-9584
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Country | US
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Telephone | 304-785-1528
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 03445209
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License Number State | OH
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