MEDICARE: COURTNEY JABLONSKI STNA

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	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1679003479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY JABLONSKI STNA

Provider Business Mailing Address
First Line	:	1307 CAMDEN ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43605-3076
Country	:	US
Telephone Number	:	419-490-4856
Fax Number	:

Provider Business Practice Location Address
First Line	:	1307 CAMDEN ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43605-4360
Country	:	US
Telephone Number	:	419-490-4856
Fax Number	:	419-490-4856

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

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	06/14/2017

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Directions to “ COURTNEY JABLONSKI STNA” Practice Location

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