Individual provider Active NPI

Jeannette Justine Jenson, LPN

  • Licensed Practical Nurse
  • Milwaukee, WI
National Provider Identifier
1578856878
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
29733-31 Issued in WI
Practice address
2504 W Grant St
Milwaukee, WI 53215-2535
Phone
(414) 324-6769
NPI assigned
May 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 29733-31 WI Primary

Addresses

Primary practice location

2504 W Grant St
Milwaukee, WI 53215-2535

Mailing address

2504 W Grant St
Milwaukee, WI 53215-2535
Phone (414) 324-6769

Other names 1

  • Jeannette Justine Eggett Former name

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
29733-31WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1578856878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 W GRANT ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152535",
            "telephone_number": "414-324-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 W GRANT ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152535",
            "telephone_number": "414-324-6769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSON",
        "first_name": "JEANNETTE",
        "middle_name": "JUSTINE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-18",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "29733-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNETTE",
            "last_name": "EGGETT",
            "middle_name": "JUSTINE",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; 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.