Individual
JELYN LANEER GARDNER BURNSIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
STNA
Contact information
Practice address
2036 WILMICH DR, AKRON, OH 44319-1230
(330) 958-6611
Mailing address
2036 WILMICH DR, AKRON, OH 44319-1230
(330) 958-6611
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
402266400620
OH
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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