Individual
MRS. JESSICA ELYSE GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
4774 KIDRON RD, KIDRON, OH 44636
(330) 857-0177
Mailing address
4774 KIDRON RD, PO BOX 247, KIDRON, OH 44636
(330) 857-0177
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
045197
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2164394
—
OH
Enumeration date
08/29/2005
Last updated
09/07/2011
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