Provider Demographics
NPI:1609037886
Name:POLT, JAIME M (CRNA)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:M
Last Name:POLT
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:40 W ERIE ST
Mailing Address - Street 2:STE 203
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-3274
Mailing Address - Country:US
Mailing Address - Phone:440-350-0832
Mailing Address - Fax:440-354-7420
Practice Address - Street 1:40 W ERIE ST
Practice Address - Street 2:STE 203
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3274
Practice Address - Country:US
Practice Address - Phone:440-350-0832
Practice Address - Fax:440-354-7420
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2012-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH80373367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered