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NPI Code Detail

MEDICARE: JINX MASTNEY LPN

MEDICARE: JINX MASTNEY LPN
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
1164W00000XLicensed Practical NursePN.067041-MEDSOH

General Provider Information

NPI Number : 1821524083
Entity Type Code : Individual
Provider Name (Legal Business Name) : JINX MASTNEY LPN
Provider Business Mailing Address
First Line : 27216 COOK RD. TRL 41
Second Line :
City : OLMSTED TWP
State : OH
Zip : 44138
Country : US
Telephone Number : 440-241-8685
Fax Number :
Provider Business Practice Location Address
First Line : 2301 SCRANTON RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-4311
Country : US
Telephone Number : 216-273-6998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2017
Last Update Date : 05/10/2017

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