Provider Demographics
NPI:1194592667
Name:PIATT, JOLENE DENISE
Entity type:Individual
Prefix:
First Name:JOLENE
Middle Name:DENISE
Last Name:PIATT
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 1:12 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45146-3323
Mailing Address - Country:US
Mailing Address - Phone:937-218-3437
Mailing Address - Fax:
Practice Address - Street 1:12 HIGH ST
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45146-3323
Practice Address - Country:US
Practice Address - Phone:937-218-3437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker