Provider Demographics
NPI:1972927234
Name:JEANTY, CLAIRE A (ARNP)
Entity type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:A
Last Name:JEANTY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 NW 9TH TER APT 306
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3951
Mailing Address - Country:US
Mailing Address - Phone:305-467-5476
Mailing Address - Fax:
Practice Address - Street 1:1500 E HILLSBORO BLVD
Practice Address - Street 2:207
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4355
Practice Address - Country:US
Practice Address - Phone:954-428-2480
Practice Address - Fax:954-428-2904
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9347139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily