Provider Demographics
NPI:1245795517
Name:JEAN-PIERRE, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:JEAN-PIERRE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 BEACH 19TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4423
Mailing Address - Country:US
Mailing Address - Phone:718-869-7000
Mailing Address - Fax:
Practice Address - Street 1:1554 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4667
Practice Address - Country:US
Practice Address - Phone:703-841-0703
Practice Address - Fax:571-297-9809
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024183440363LF0000X
390200000X
MDR226432363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program