Phillips, Jessica Marie

Phillips, Jessica Marie is an sole proprietor health care provider with primary practice located at 16118 Huntmere Ave , Cleveland OH 44110-1545. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Licensed Practical Nurse, Agencies / Day Training, Developmentally Disabled Services, Other Service Providers / Community Health Worker. Nursing Service Providers / Licensed Practical Nurse is her primary health care specialty. Phillips, Jessica Marie can be contacted via phone (216) 322-1852.

Contact Information

Primary practice address
16118 Huntmere Ave Cleveland OH 44110-1545
Phone: (216) 322-1852
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X PN146071 Ohio
Agencies / Day Training, Developmentally Disabled Services 251C00000X PN146071 Ohio
Other Service Providers / Community Health Worker 172V00000X 146071 Ohio

Profile Details

NPI number 1467716464
LBN Legal business name Phillips, Jessica Marie
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 25th, 2012
Last updated Dec 9th, 2015 - about 11 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 1467716464 NPPES
Ohio MEDICAID 0077930

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