Provider Demographics
NPI:1699043034
Name:JEAN-PHILIPPE, JASMINE (LPN)
Entity Type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:
Last Name:JEAN-PHILIPPE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 E 103RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4522
Mailing Address - Country:US
Mailing Address - Phone:917-538-6575
Mailing Address - Fax:
Practice Address - Street 1:1070 E 103RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4522
Practice Address - Country:US
Practice Address - Phone:917-538-6575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306792-1164W00000X
NJ26NP06621200164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse