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General NPI Number Information
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NPI Number | 1912778887
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Entity Type | Individual
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Provider Name | JACQUELYN HOPE MYMO CNP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2024
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 1044 BELMONT AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44504-1006
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Country | US
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Telephone | 330-480-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 909 JOHN ST
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City | NILES
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State | OH
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Zip | 44446-1912
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Country | US
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Telephone | 330-219-6359
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0035649
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License Number State | OH
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