Provider Demographics
NPI:1912261355
Name:NEVINS, JUEL MARIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:JUEL
Middle Name:MARIE
Last Name:NEVINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-2825
Mailing Address - Country:US
Mailing Address - Phone:404-934-9683
Mailing Address - Fax:
Practice Address - Street 1:17 MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-2825
Practice Address - Country:US
Practice Address - Phone:404-934-9683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN068670164W00000X
CT030609164W00000X
NY317332164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse