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 |