Provider Demographics
NPI:1972805687
Name:JEAN, FLEUVIO (LPN)
Entity Type:Individual
Prefix:MR
First Name:FLEUVIO
Middle Name:
Last Name:JEAN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 VALLEYWOOD DR SE
Mailing Address - Street 2:G6
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-5707
Mailing Address - Country:US
Mailing Address - Phone:845-520-1732
Mailing Address - Fax:845-520-5042
Practice Address - Street 1:2301 VALLEYWOOD DR SE
Practice Address - Street 2:G6
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-5707
Practice Address - Country:US
Practice Address - Phone:845-520-1732
Practice Address - Fax:845-520-5042
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301917164W00000X
MI4703119527164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse