Provider Demographics
NPI:1285089771
Name:BILLINGLSEA, JEANANE T
Entity type:Individual
Prefix:
First Name:JEANANE
Middle Name:T
Last Name:BILLINGLSEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 MANOTAK POINT DR UNIT 2016
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-1189
Mailing Address - Country:US
Mailing Address - Phone:904-859-2121
Mailing Address - Fax:
Practice Address - Street 1:1466 MANOTAK POINT DR UNIT 2016
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-1189
Practice Address - Country:US
Practice Address - Phone:904-859-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion