MEDICARE: JAMIE DARLENE PAPPAS

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	363LF0000X	Family Nurse Practitioner	0028484	OH

General Provider Information

NPI Number	:	1902503535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE DARLENE PAPPAS

Provider Business Mailing Address
First Line	:	6029 HANNA RD
Second Line	:
City	:	RAVENNA
State	:	OH
Zip	:	44266-8534
Country	:	US
Telephone Number	:	313-898-4724
Fax Number	:

Provider Business Practice Location Address
First Line	:	1706 W MARKET ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313-7002
Country	:	US
Telephone Number	:	234-222-1744
Fax Number	:

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

Provider Enumeration Date	:	02/14/2023
Last Update Date	:	02/14/2023

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