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General NPI Number Information
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NPI Number | 1780372052
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Entity Type | Individual
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Provider Name | JINA MARIE MEZA
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Gender | Female
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Dates
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Enumeration Date | 04/25/2023
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 304 N COLLINGWOOD AVE
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City | FREMONT
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State | OH
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Zip | 43420-4322
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Country | US
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Telephone | 419-334-1354
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 WESTERN AVE
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City | FREMONT
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State | OH
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Zip | 43420-1621
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Country | US
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Telephone | 419-307-8277
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Fax | 419-334-9530
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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