Provider Demographics
NPI:1124796651
Name:DUETSCH, JEAN RASMUSSEN (CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:RASMUSSEN
Last Name:DUETSCH
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-7081
Mailing Address - Country:US
Mailing Address - Phone:540-953-5409
Mailing Address - Fax:
Practice Address - Street 1:1871 GREENBRIER CIR
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-9280
Practice Address - Country:US
Practice Address - Phone:540-922-3618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001154971163WL0100X
VA0024182559363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant