Individual
JAEVIONNA CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
896 STEVENSON RD LOWR, CLEVELAND, OH 44110-3153
(216) 287-0579
Mailing address
896 STEVENSON RD LOWR, CLEVELAND, OH 44110-3153
(216) 287-0579
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.188854
OH
Other
Enumeration date
03/08/2025
Last updated
03/08/2025
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