Individual
JENA NICOLE LANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
2040 BEACHY RD NW, SUGARCREEK, OH 44681-8103
(937) 564-4903
Mailing address
2040 BEACHY RD NW, SUGARCREEK, OH 44681-8103
(937) 564-4903
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225
1225
—
Enumeration date
06/22/2021
Last updated
08/20/2021
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