Healthcare Provider Details

I. General information

NPI: 1700874575
Provider Name (Legal Business Name): JEANNE BATTENBURG N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 OAK BAY ROAD
PORT HADLOCK WA
98339
US

IV. Provider business mailing address

PO BOX 1566
PORT HADLOCK WA
98339-1566
US

V. Phone/Fax

Practice location:
  • Phone: 360-379-6737
  • Fax: 360-379-6518
Mailing address:
  • Phone: 360-379-2725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30007494
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: