Provider Demographics
NPI:1962190579
Name:CHAMBERS, JESSICA J (DOO)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:J
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:DOO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 46245
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45246-0245
Mailing Address - Country:US
Mailing Address - Phone:513-766-6950
Mailing Address - Fax:513-996-0166
Practice Address - Street 1:10921 REED HARTMAN HWY STE 324
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2849
Practice Address - Country:US
Practice Address - Phone:513-996-0165
Practice Address - Fax:513-996-0166
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health