Provider Demographics
NPI:1972970838
Name:PINKARD, JEAN (FNP-C)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:PINKARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27835 BERRYWOOD LN
Mailing Address - Street 2:UNIT #56
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4053
Mailing Address - Country:US
Mailing Address - Phone:248-790-5205
Mailing Address - Fax:
Practice Address - Street 1:25 OWEN ST
Practice Address - Street 2:UNIT #56
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-2921
Practice Address - Country:US
Practice Address - Phone:734-699-5400
Practice Address - Fax:734-699-5455
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704164057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily