Provider Demographics
NPI:1891978664
Name:LOUIS-JEUNE, SERGE
Entity Type:Individual
Prefix:MR
First Name:SERGE
Middle Name:
Last Name:LOUIS-JEUNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1976 WELLSFORD DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-6755
Mailing Address - Country:US
Mailing Address - Phone:757-721-5222
Mailing Address - Fax:
Practice Address - Street 1:1976 WELLSFORD DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-6755
Practice Address - Country:US
Practice Address - Phone:757-721-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide