Provider Demographics
NPI:1902525132
Name:CUENCA, JASMINE ROSE
Entity Type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:ROSE
Last Name:CUENCA
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 1:15 PHILLIP RD
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-4324
Mailing Address - Country:US
Mailing Address - Phone:603-548-8143
Mailing Address - Fax:
Practice Address - Street 1:1223 W 6TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-1354
Practice Address - Country:US
Practice Address - Phone:216-687-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program