Cervantes, Jackie
Cervantes, Jackie is an sole proprietor health care provider with primary practice located at 308 Jack Roush Way , Manchester OH 45144-1423. She recently has only one registered license in Nursing Service Related Providers / Home Health Aide, which is considered as her primary health care specialty. Cervantes, Jackie can be contacted via phone (937) 549-8502.Contact Information
Primary practice address
308 Jack Roush Way
Manchester OH 45144-1423
Phone: (937) 549-8502
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Home Health Aide | 374U00000X | 2627456 | Ohio |
Profile Details
| NPI number | 1629197009 |
|---|---|
| LBN Legal business name | Cervantes, Jackie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 28th, 2007 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629197009 | NPPES |
| Ohio | MEDICAID | 2627456 |
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