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General NPI Number Information
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NPI Number | 1265188015
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Entity Type | Individual
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Provider Name | MIRELLE JUMEAU RN,BSN,CVRN,BC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 479 HEMPSTEAD TPKE STE C
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City | ELMONT
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State | NY
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Zip | 11003-1602
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Country | US
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Telephone | 516-395-1073
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Fax | 516-544-6621
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Provider Business Mailing Address
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Address Line | 479 HEMPSTEAD TPKE STE C
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City | ELMONT
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State | NY
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Zip | 11003-1602
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Country | US
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Telephone | 516-395-1073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 6613301
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | 6613301
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 661330-1
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License Number State | NY
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