Provider Demographics
NPI:1306592035
Name:WARE, JAZ'MYNE L (BSSW)
Entity type:Individual
Prefix:
First Name:JAZ'MYNE
Middle Name:L
Last Name:WARE
Suffix:
Gender:F
Credentials:BSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 REG SMITH CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40208-2746
Mailing Address - Country:US
Mailing Address - Phone:502-584-8090
Mailing Address - Fax:
Practice Address - Street 1:403 REG SMITH CIR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-2746
Practice Address - Country:US
Practice Address - Phone:502-584-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program