Provider Demographics
NPI:1386422442
Name:FERNEKEES, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:FERNEKEES
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 1:602 ASH ST
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:OH
Mailing Address - Zip Code:44890-1539
Mailing Address - Country:US
Mailing Address - Phone:419-577-8446
Mailing Address - Fax:
Practice Address - Street 1:602 ASH ST
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:OH
Practice Address - Zip Code:44890-1539
Practice Address - Country:US
Practice Address - Phone:419-577-8446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider