Individual
JALISA PERNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3931 BROOKLYN AVE, CLEVELAND, OH 44109-3809
(216) 703-1558
(216) 703-1558
Mailing address
3931 BROOKLYN AVE, CLEVELAND, OH 44109-3809
(216) 703-1558
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.162636.MEDS-IV
OH
Other
Enumeration date
08/31/2017
Last updated
08/31/2017
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