Provider Demographics
NPI:1841737046
Name:POSTELLI, JEANETTE O'NEILL (NP)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:O'NEILL
Last Name:POSTELLI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 HEALTH PARK LN
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-3421
Mailing Address - Country:US
Mailing Address - Phone:269-429-7100
Mailing Address - Fax:269-429-1959
Practice Address - Street 1:4025 HEALTH PARK LN
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-3421
Practice Address - Country:US
Practice Address - Phone:269-429-7100
Practice Address - Fax:269-429-1959
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704264413363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1841737046Medicaid
MI4704264413OtherLICENSE
MI1841737046Medicaid