Provider Demographics
NPI:1497010797
Name:JELENOVIC, NACHELLE
Entity Type:Individual
Prefix:
First Name:NACHELLE
Middle Name:
Last Name:JELENOVIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GREENWOOD VILLAGE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-2718
Mailing Address - Country:US
Mailing Address - Phone:207-751-8974
Mailing Address - Fax:
Practice Address - Street 1:20 GREENWOOD VILLAGE ST
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-2718
Practice Address - Country:US
Practice Address - Phone:207-751-8974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist