Provider Demographics
NPI:1942879374
Name:ARELLANO, JENNIFER L (RN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:ARELLANO
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:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-0903
Mailing Address - Country:US
Mailing Address - Phone:254-394-2483
Mailing Address - Fax:
Practice Address - Street 1:3100 NC 226 S
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-8741
Practice Address - Country:US
Practice Address - Phone:828-655-3231
Practice Address - Fax:828-378-0229
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX856436163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse