Provider Demographics
NPI:1124706478
Name:DYER, JESSICA MARIE
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:DYER
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 1:3359 STATE ROUTE 13 SE
Mailing Address - Street 2:
Mailing Address - City:CROOKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43731-9553
Mailing Address - Country:US
Mailing Address - Phone:740-963-5387
Mailing Address - Fax:
Practice Address - Street 1:3359 STATE ROUTE 13 SE
Practice Address - Street 2:
Practice Address - City:CROOKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43731-9553
Practice Address - Country:US
Practice Address - Phone:740-963-5387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker