Individual
MS. BETTYE LOU JEMISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
585 EAST 266TH ST, EUCLID, OH 44132
(216) 509-9973
Mailing address
493 EAST 149TH ST, CLEVELAND, OH 44110
(216) 509-9973
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN037381
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2310001
—
OH
Enumeration date
07/06/2007
Last updated
07/08/2007
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