Provider Demographics
NPI:1134847676
Name:JOLIVET APRN MEDICAL LLC
Entity type:Organization
Organization Name:JOLIVET APRN MEDICAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER/HEALTHCARE PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLIVET-CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:409-526-3741
Mailing Address - Street 1:1322 SPACE PARK DR STE B180
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3477
Mailing Address - Country:US
Mailing Address - Phone:832-225-2709
Mailing Address - Fax:409-217-5086
Practice Address - Street 1:1322 SPACE PARK DR STE B180
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3477
Practice Address - Country:US
Practice Address - Phone:832-225-2709
Practice Address - Fax:409-217-5086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service