MEDICARE: MS. DENISE HERARD JEANLOUIS ADN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	368210	OH

General Provider Information

NPI Number	:	1851680268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DENISE HERARD JEANLOUIS ADN

Provider Business Mailing Address
First Line	:	4657 TAMARACK BLVD
Second Line	:	APT B-12
City	:	COLUMBUS
State	:	OH
Zip	:	43229
Country	:	US
Telephone Number	:	614-785-1649
Fax Number	:

Provider Business Practice Location Address
First Line	:	4657 TAMARACK BLVD
Second Line	:	APT B-12
City	:	COLUMBUS
State	:	OH
Zip	:	43229
Country	:	US
Telephone Number	:	614-785-1649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	04/11/2011

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