Provider Demographics
NPI:1982011060
Name:JEAN, ALDRIDGE (ARNP)
Entity type:Individual
Prefix:
First Name:ALDRIDGE
Middle Name:
Last Name:JEAN
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 1:374 OAK SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-3539
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9201 E MOUNTAIN VIEW RD STE 220
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5172
Practice Address - Country:US
Practice Address - Phone:877-564-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9327361363LA2200X
GARN242150363LA2200X
WAAP61463666363LA2200X
CA95026289363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95026289OtherCALIFORNIA BOARD OF REGISTERED NURSING
FLARNP9327361OtherFL DEPT OF HEALTH
GARN242150OtherGEORGIA SECRETARY OF STATE
WAAP61463666OtherWASHINGTON STATE DEPT. OF HEALTH