Provider Demographics
NPI:1023522109
Name:JEANS, CLOE JADE (PA-C)
Entity type:Individual
Prefix:
First Name:CLOE
Middle Name:JADE
Last Name:JEANS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CLOE
Other - Middle Name:JADE
Other - Last Name:DEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5578 LONGLEY LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1825
Mailing Address - Country:US
Mailing Address - Phone:406-599-6607
Mailing Address - Fax:
Practice Address - Street 1:5578 LONGLEY LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1825
Practice Address - Country:US
Practice Address - Phone:775-284-8650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant