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NPI Code Detail

MEDICARE: JEANE-MARIE LEDBETTER RN

MEDICARE: JEANE-MARIE LEDBETTER RN
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
1163WH0200XHome Health Registered Nurse555472CA

General Provider Information

NPI Number : 1558531574
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANE-MARIE LEDBETTER RN
Provider Business Mailing Address
First Line : 6330 RUGBY AVE
Second Line : #200
City : HUNTINGTON PARK
State : CA
Zip : 90255-4066
Country : US
Telephone Number : 323-277-7678
Fax Number :
Provider Business Practice Location Address
First Line : 2040 CAMFIELD AVE
Second Line :
City : COMMERCE
State : CA
Zip : 90040-1502
Country : US
Telephone Number : 555-555-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2008
Last Update Date : 07/15/2016

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