Provider Demographics
NPI:1306683503
Name:PARMER, JESSICA BROOKE
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:BROOKE
Last Name:PARMER
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 1:1267 GANGES EAST RD
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:OH
Mailing Address - Zip Code:44878-8889
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1267 GANGES EAST RD
Practice Address - Street 2:
Practice Address - City:SHILOH
Practice Address - State:OH
Practice Address - Zip Code:44878-8889
Practice Address - Country:US
Practice Address - Phone:419-566-9543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSW471757343900000X, 347C00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle