Provider Demographics
NPI:1104637867
Name:WINGATE, JAYLEE FAITH
Entity type:Individual
Prefix:
First Name:JAYLEE
Middle Name:FAITH
Last Name:WINGATE
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 1:3838 STEINER RD
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:OH
Mailing Address - Zip Code:44217-9489
Mailing Address - Country:US
Mailing Address - Phone:330-203-3234
Mailing Address - Fax:
Practice Address - Street 1:3838 STEINER RD
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:OH
Practice Address - Zip Code:44217-9489
Practice Address - Country:US
Practice Address - Phone:330-203-3234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide