Provider Demographics
NPI:1457032765
Name:DEAN, JACQUELINE C (RN)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:C
Last Name:DEAN
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:4500 SAN PABLO ROAD
Mailing Address - Street 2:MANGURIAN BLDG 4TH FLOOR
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-1865
Mailing Address - Country:US
Mailing Address - Phone:904-956-3435
Mailing Address - Fax:
Practice Address - Street 1:4500 SAN PABLO ROAD
Practice Address - Street 2:MANGURIAN BLDG 4TH FLOOR
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-1865
Practice Address - Country:US
Practice Address - Phone:904-956-3435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN9325530163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience