Individual
JAMARIAN JEVON HAWTHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7813 BEULAH CHURCH RD UNIT 110, LOUISVILLE, KY 40228-1773
(502) 975-1733
Mailing address
7813 BEULAH CHURCH RD UNIT 110, LOUISVILLE, KY 40228-1773
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
850751282
IRS
—
Enumeration date
07/06/2020
Last updated
03/27/2021
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