Provider Demographics
NPI:1164283669
Name:MIDDLETON, JOCELYN ANQUINETTE (RN)
Entity Type:Individual
Prefix:MISS
First Name:JOCELYN
Middle Name:ANQUINETTE
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6605 PHEASANT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-7109
Mailing Address - Country:US
Mailing Address - Phone:937-396-4434
Mailing Address - Fax:
Practice Address - Street 1:6605 PHEASANT RIDGE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-7109
Practice Address - Country:US
Practice Address - Phone:937-396-4434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH425170163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse