Provider Demographics
NPI:1285301374
Name:JEAN-BAPTISTE, MARIE PAULENE (PMHNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:PAULENE
Last Name:JEAN-BAPTISTE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 S VAL VISTA DR BLDG 8
Mailing Address - Street 2:STE 143
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295
Mailing Address - Country:US
Mailing Address - Phone:631-507-0051
Mailing Address - Fax:
Practice Address - Street 1:2680 S VAL VISTA DR STE 143
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1621
Practice Address - Country:US
Practice Address - Phone:631-507-0051
Practice Address - Fax:800-861-6533
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ263008363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health