Healthcare Provider Details

I. General information

NPI: 1508665654
Provider Name (Legal Business Name): DEBRA LEE JEZARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 COURT ST
TAUNTON MA
02780-3201
US

IV. Provider business mailing address

54 COURT ST
TAUNTON MA
02780-3201
US

V. Phone/Fax

Practice location:
  • Phone: 774-281-0676
  • Fax: 877-708-9792
Mailing address:
  • Phone: 617-842-5683
  • Fax: 877-708-9792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN218255
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: