Provider Demographics
NPI:1275815235
Name:URSING, JEANINE ROSE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JEANINE
Middle Name:ROSE
Last Name:URSING
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19725 ALLEN RD
Mailing Address - Street 2:STE 101
Mailing Address - City:BROWNSTOWN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1090
Mailing Address - Country:US
Mailing Address - Phone:313-971-8931
Mailing Address - Fax:
Practice Address - Street 1:19725 ALLEN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-1090
Practice Address - Country:US
Practice Address - Phone:734-479-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704266652363LP2300X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care