Provider Demographics
NPI:1770909772
Name:VERNE, JENNIFER R (RN)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:R
Last Name:VERNE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5351 BRANDY AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-9585
Mailing Address - Country:US
Mailing Address - Phone:269-353-6547
Mailing Address - Fax:
Practice Address - Street 1:5351 BRANDY AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-9585
Practice Address - Country:US
Practice Address - Phone:269-353-6547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704303890163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse