Provider Demographics
NPI:1750648259
Name:MCGHEE, JAMIE M
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:M
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:M
Other - Last Name:SANTIAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PN
Mailing Address - Street 1:2238 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-2026
Mailing Address - Country:US
Mailing Address - Phone:440-654-9626
Mailing Address - Fax:
Practice Address - Street 1:2238 E 34TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055
Practice Address - Country:US
Practice Address - Phone:440-654-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH143111164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse