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NPI Code Detail

MEDICARE: JADE MARIE VANWASHENOVA

MEDICARE: JADE MARIE VANWASHENOVA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1215880620
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADE MARIE VANWASHENOVA
Provider Business Mailing Address
First Line : 65 MESSIMER DR
Second Line :
City : NEWARK
State : OH
Zip : 43055-1874
Country : US
Telephone Number : 740-522-8477
Fax Number :
Provider Business Practice Location Address
First Line : 65 MESSIMER DR
Second Line :
City : NEWARK
State : OH
Zip : 43055-1874
Country : US
Telephone Number : 740-522-8477
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 02/16/2026

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Directions to “ JADE MARIE VANWASHENOVA ” Practice Location

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