Provider Demographics
NPI:1063397529
Name:EARLE, JAMEKA (COSMETOLOGIST)
Entity type:Individual
Prefix:
First Name:JAMEKA
Middle Name:
Last Name:EARLE
Suffix:
Gender:X
Credentials:COSMETOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 ROMANY CT
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-9346
Mailing Address - Country:US
Mailing Address - Phone:864-510-9197
Mailing Address - Fax:
Practice Address - Street 1:1326 ROMANY CT
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316-9346
Practice Address - Country:US
Practice Address - Phone:864-510-9197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC90092335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier