Provider Demographics
NPI:1306213871
Name:MYDLENSKI, JEANNINE MARIE (BS, RRT-NPS)
Entity Type:Individual
Prefix:MS
First Name:JEANNINE
Middle Name:MARIE
Last Name:MYDLENSKI
Suffix:
Gender:F
Credentials:BS, RRT-NPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 WATER ISLAND
Mailing Address - Street 2:
Mailing Address - City:ST. THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802
Mailing Address - Country:US
Mailing Address - Phone:340-513-2908
Mailing Address - Fax:
Practice Address - Street 1:9048 SUGAR ESTATE
Practice Address - Street 2:
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2908
Practice Address - Country:US
Practice Address - Phone:340-513-2908
Practice Address - Fax:340-513-2908
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care