Provider Demographics
NPI:1689499360
Name:ALEXANDER, JASMINE M
Entity type:Individual
Prefix:MISS
First Name:JASMINE
Middle Name:M
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 ANSEL RD APT 64
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-4100
Mailing Address - Country:US
Mailing Address - Phone:216-308-1645
Mailing Address - Fax:
Practice Address - Street 1:1661 ANSEL RD APT 64
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-4100
Practice Address - Country:US
Practice Address - Phone:216-308-1645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker