| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JEAN DOUGLAS | 1891519518 | 2024-11-09 |
Jean Douglas is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1891519518. Registration indicates Jean Douglas is a provider of services with a specialization in Nursing Service Providers, Registered Nurse (Registered Nurse, ) (All Other Specialties & Provider Types, ) (Registered Nurse, Nursing Service Providers)
| Entity Type | Individual |
| Provider Name | Jean Douglas |
| Practice Office Address | 10643 GENTRY LN SW ALBUQUERQUE, NM US |
| Practice Office Telephone | 5052755300 |
| Mailing Address | 10643 GENTRY LN SW ALBUQUERQUE, NM 871213687 US |
| Business Telephone | 5052755300 |
| Code | Practice | License No State |
|---|---|---|
| 163W00000X PRIMARY | Nursing Service Providers Registered Nurse Registered Nurse All Other Specialties & Provider Types Registered Nurse Nursing Service Providers | 64385
NM |