Provider Demographics
NPI:1043437429
Name:DAHLBECK, JEAN CLAY (RN, MS, ANP-C)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:CLAY
Last Name:DAHLBECK
Suffix:
Gender:F
Credentials:RN, MS, ANP-C
Other - Prefix:MS
Other - First Name:JEAN
Other - Middle Name:C
Other - Last Name:RILEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MS, ANP-C
Mailing Address - Street 1:2605 LYNCHBURG ST
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860
Mailing Address - Country:US
Mailing Address - Phone:804-815-6732
Mailing Address - Fax:
Practice Address - Street 1:700 24TH ST
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:VA
Practice Address - Zip Code:23801-1716
Practice Address - Country:US
Practice Address - Phone:804-734-9057
Practice Address - Fax:804-734-9969
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167053363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner