Provider Demographics
NPI:1730654393
Name:JEAN-LOUIS, MARYSE VERONICA (RN, HN-C)
Entity Type:Individual
Prefix:
First Name:MARYSE
Middle Name:VERONICA
Last Name:JEAN-LOUIS
Suffix:
Gender:F
Credentials:RN, HN-C
Other - Prefix:
Other - First Name:M. VERONICA
Other - Middle Name:
Other - Last Name:JEAN-LOUIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, HN-C
Mailing Address - Street 1:3660 NE 166TH ST APT 312
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3820
Mailing Address - Country:US
Mailing Address - Phone:678-777-0607
Mailing Address - Fax:
Practice Address - Street 1:633 NE 167TH ST STE 1016
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2448
Practice Address - Country:US
Practice Address - Phone:305-783-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9277487163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse