Individual provider Active NPI

Jeanine Quetant Jr.

  • Registered Nurse
  • Jackson, MI
National Provider Identifier
1255733937
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704294357 Issued in MI
Practice address
520 Wintercrest Dr
Jackson, MI 49203-1195
Phone
(517) 787-2446
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704294357 MI Primary

Addresses

Primary practice location

520 Wintercrest Dr
Jackson, MI 49203-1195

Mailing address

520 Wintercrest Dr
Jackson, MI 49203-1195
Phone (517) 787-2446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704294357MIMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1255733937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 WINTERCREST DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492031195",
            "telephone_number": "517-787-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WINTERCREST DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492031195",
            "telephone_number": "517-787-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUETANT",
        "first_name": "JEANINE",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704294357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.