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Individual
JESSICA M ROACH
Active
Individual
JESSICA M ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN, MPH
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.100395.MEDS-IV
OH
251K00000X
Public Health or Welfare Agency
—
—
261QP0904X
Federal Public Health Clinic/Center
—
—
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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