Individual
JENICA KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
38882 MENTOR AVE, WILLOUGHBY, OH 44094-7875
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.461294
OH
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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