Provider Demographics
NPI:1609513373
Name:LOUIS-JEUNE, VLADIMIR (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:LOUIS-JEUNE
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 E BATTLEFIELD RD STE A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-3878
Mailing Address - Country:US
Mailing Address - Phone:417-447-8664
Mailing Address - Fax:
Practice Address - Street 1:1902 E BATTLEFIELD RD STE A
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-3878
Practice Address - Country:US
Practice Address - Phone:417-434-3554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023011185163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical