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NPI Code Detail

MEDICARE: JACQUELINE HENDON

MEDICARE: JACQUELINE HENDON
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
1374J00000XDoula0000OH

General Provider Information

NPI Number : 1861214504
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE HENDON
Provider Business Mailing Address
First Line : 507 MINEOLA AVE
Second Line :
City : AKRON
State : OH
Zip : 44320-1928
Country : US
Telephone Number : 330-634-5534
Fax Number :
Provider Business Practice Location Address
First Line : 3043 SUPERIOR AVE E
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-4349
Country : US
Telephone Number : 216-307-1538
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2024
Last Update Date : 10/24/2024

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Directions to “ JACQUELINE HENDON ” Practice Location

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