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Individual

JESSE WORLUMARTI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
413 VANIMAN AVE, TROTWOOD, OH 45426-2529
(732) 762-5834
Mailing address
413 VANIMAN AVE, TROTWOOD, OH 45426-2529
(732) 762-5834

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
5712447
OH
376K00000X
Nurse's Aide
400795720808
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3154063
OH
05
5712447
OH
Enumeration date
03/21/2019
Last updated
03/21/2019
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