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NPI Code Detail

MEDICARE: JENNIFER JUNNE VINCENT RN

MEDICARE: JENNIFER JUNNE VINCENT 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
1163W00000XRegistered Nurse4704288314MI

General Provider Information

NPI Number : 1831535376
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER JUNNE VINCENT RN
Provider Business Mailing Address
First Line : 215 W 3RD ST
Second Line :
City : EVART
State : MI
Zip : 49631-9590
Country : US
Telephone Number : 989-339-0142
Fax Number :
Provider Business Practice Location Address
First Line : 209 E CHIPPEWA ST
Second Line :
City : MT PLEASANT
State : MI
Zip : 48858-1609
Country : US
Telephone Number : 989-772-1261
Fax Number : 989-772-1300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2013
Last Update Date : 05/10/2013

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