Individual
MRS. JACKIE MARIE UJCICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
135 5TH AVE, CHARDON, OH 44024-1005
(440) 279-8224
Mailing address
393 KAREN DR, CHARDON, OH 44024-1425
(440) 279-8224
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN105027
OH
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/19/2012
Last updated
10/05/2020
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