MEDICARE: SALMA HASSAN JAEGERS

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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1568151116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALMA HASSAN JAEGERS

Provider Business Mailing Address
First Line	:	12082 COUNTY ROAD 4001
Second Line	:
City	:	HOLTS SUMMIT
State	:	MO
Zip	:	65043-2538
Country	:	US
Telephone Number	:	573-301-6066
Fax Number	:

Provider Business Practice Location Address
First Line	:	705 JEFFERSON ST
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65101-2941
Country	:	US
Telephone Number	:	573-301-6066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	05/01/2023

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