1992099477 NPI number — DEBBIE JOYCE JEANOTTE REGISTERED NURSE

Table of content: DEBBIE JOYCE JEANOTTE REGISTERED NURSE (NPI 1992099477)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992099477 NPI number — DEBBIE JOYCE JEANOTTE REGISTERED NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JEANOTTE
Provider First Name:
DEBBIE
Provider Middle Name:
JOYCE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
REGISTERED NURSE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHROEDER
Provider Other First Name:
DEBBIE
Provider Other Middle Name:
JOYCE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992099477
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/02/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 MINNE-TOHE DRIVE
Provider Second Line Business Mailing Address:
MINNE-TOHE HEALTH CENTER
Provider Business Mailing Address City Name:
NEW TOWN
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58763
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-627-7971
Provider Business Mailing Address Fax Number:
701-627-2805

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 MINNE-TOHE DRIVE
Provider Second Line Business Practice Location Address:
MINNE-TOHE HEALTH CENTER
Provider Business Practice Location Address City Name:
NEW TOWN
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58763
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-627-7971
Provider Business Practice Location Address Fax Number:
701-627-2805
Provider Enumeration Date:
06/02/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WC2100X , with the licence number:  R25955 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)