Provider Demographics
NPI:1528316825
Name:ANDREWS, JASMINE RENEE (RN)
Entity type:Individual
Prefix:MISS
First Name:JASMINE
Middle Name:RENEE
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18072 WOODINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-2561
Mailing Address - Country:US
Mailing Address - Phone:313-828-3020
Mailing Address - Fax:
Practice Address - Street 1:18072 WOODINGHAM DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-2561
Practice Address - Country:US
Practice Address - Phone:313-828-3020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-17
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities