Basic Information
| Provider Information | |||||||||
| NPI: | 1295451920 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAECK | ||||||||
| FirstName: | JAMMIE | ||||||||
| MiddleName: | LEIGH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 615 ELSINORE PL STE 200 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452021457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8335104357 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1830 W HIGH ST | ||||||||
| Address2: | |||||||||
| City: | PIQUA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453569399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8335104357 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2022 | ||||||||
| LastUpdateDate: | 10/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN.485835 | OH | Y | Nursing Service Providers | Registered Nurse |
No ID Information.