Individual
JAZZMEN BLANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
5501 OLD DOVER BLVD APT 1, FORT WAYNE, IN 46835-2851
(260) 445-0633
Mailing address
5501 OLD DOVER BLVD APT 1, FORT WAYNE, IN 46835-2851
(260) 445-0633
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA2503256
IN
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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