Provider Demographics
NPI:1194085597
Name:JEANPHILIPPE, JEANNE H
Entity type:Individual
Prefix:MISS
First Name:JEANNE
Middle Name:H
Last Name:JEANPHILIPPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:H
Other - Last Name:JEANPHILIPPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:5939 W GREEN BROOK DR
Mailing Address - Street 2:
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53223-2336
Mailing Address - Country:US
Mailing Address - Phone:619-339-1081
Mailing Address - Fax:
Practice Address - Street 1:5939 W GREEN BROOK DR
Practice Address - Street 2:
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53223-2336
Practice Address - Country:US
Practice Address - Phone:619-339-1081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI166705-30163W00000X
CA735742163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse