Provider Demographics
NPI:1477828044
Name:ENLOW, JENEE PATRICIA (LVN)
Entity Type:Individual
Prefix:
First Name:JENEE
Middle Name:PATRICIA
Last Name:ENLOW
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 FALLINGSTAR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-7569
Mailing Address - Country:US
Mailing Address - Phone:949-302-0701
Mailing Address - Fax:
Practice Address - Street 1:338 FALLINGSTAR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-7569
Practice Address - Country:US
Practice Address - Phone:949-302-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN240471164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse