Provider Demographics
NPI:1992099477
Name:JEANOTTE, DEBBIE JOYCE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:JOYCE
Last Name:JEANOTTE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:JOYCE
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 MINNE-TOHE DRIVE
Mailing Address - Street 2:MINNE-TOHE HEALTH CENTER
Mailing Address - City:NEW TOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58763
Mailing Address - Country:US
Mailing Address - Phone:701-627-7971
Mailing Address - Fax:701-627-2805
Practice Address - Street 1:1 MINNE-TOHE DRIVE
Practice Address - Street 2:MINNE-TOHE HEALTH CENTER
Practice Address - City:NEW TOWN
Practice Address - State:ND
Practice Address - Zip Code:58763
Practice Address - Country:US
Practice Address - Phone:701-627-7971
Practice Address - Fax:701-627-2805
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR25955163WC2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC2100XNursing Service ProvidersRegistered NurseContinence Care