Provider Demographics
NPI:1669105383
Name:QUEZADA, JEREE MONCHELLE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:JEREE
Middle Name:MONCHELLE
Last Name:QUEZADA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5341 APRIL WIND DR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-9470
Mailing Address - Country:US
Mailing Address - Phone:910-985-7163
Mailing Address - Fax:
Practice Address - Street 1:5341 APRIL WIND DR
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-9470
Practice Address - Country:US
Practice Address - Phone:910-985-7163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-09
Last Update Date:2024-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC361387163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse