Provider Demographics
NPI:1851680268
Name:JEANLOUIS, DENISE HERARD (ADN)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:HERARD
Last Name:JEANLOUIS
Suffix:
Gender:F
Credentials:ADN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4657 TAMARACK BLVD
Mailing Address - Street 2:APT B-12
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229
Mailing Address - Country:US
Mailing Address - Phone:614-785-1649
Mailing Address - Fax:
Practice Address - Street 1:4657 TAMARACK BLVD
Practice Address - Street 2:APT B-12
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229
Practice Address - Country:US
Practice Address - Phone:614-785-1649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH368210163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse