Provider Demographics
NPI:1063086437
Name:MEADE, JAIME LYN
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:LYN
Last Name:MEADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 SILVER MAPLE WAY
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2380
Mailing Address - Country:US
Mailing Address - Phone:440-830-3412
Mailing Address - Fax:440-830-3417
Practice Address - Street 1:2101 SILVER MAPLE WAY
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-2380
Practice Address - Country:US
Practice Address - Phone:440-830-3412
Practice Address - Fax:440-830-3417
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.469429163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)