Micsky, Jodi

Micsky, Jodi is an individual health care provider with primary practice located at 715 E Western Reserve Rd , Poland OH 44514-3358. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Micsky, Jodi can be contacted via phone (330) 726-3204.

Contact Information

Primary practice address
715 E Western Reserve Rd Poland OH 44514-3358
Phone: (330) 726-3204
Fax: (330) 729-9316
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RN.296599-COA1 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X COA.16119-NP Ohio

Profile Details

NPI number 1245649615
LBN Legal business name Micsky, Jodi
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2014
Last updated Oct 2nd, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245649615 NPPES
Ohio MEDICAID 0110786

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