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NPI Code Detail

MEDICARE: MAKENSON JEAN

MEDICARE:   MAKENSON  JEAN
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
1376K00000XNurse's AideFL

General Provider Information

NPI Number : 1942703475
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKENSON JEAN
Provider Business Mailing Address
First Line : 111 CLEVELAND ST APT A6
Second Line :
City : LAKE WORTH
State : FL
Zip : 33461-4854
Country : US
Telephone Number : 561-480-6563
Fax Number :
Provider Business Practice Location Address
First Line : 111 CLEVELAND ST APT A6
Second Line :
City : LAKE WORTH
State : FL
Zip : 33461-4854
Country : US
Telephone Number : 561-480-6563
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2018
Last Update Date : 03/11/2018

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Directions to “ MAKENSON JEAN ” Practice Location

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