Provider Demographics
NPI:1770826117
Name:FRANCIS, JEANETTE YVONNE (RN)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:YVONNE
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24115 137TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1517
Mailing Address - Country:US
Mailing Address - Phone:718-413-2554
Mailing Address - Fax:
Practice Address - Street 1:24115 137TH AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-1517
Practice Address - Country:US
Practice Address - Phone:718-413-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261903163W00000X, 163WC0200X, 163WH0200X, 163WM0705X, 163WP0200X, 163WP0808X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WW0000XNursing Service ProvidersRegistered NurseWound Care