Jeanne Marie Paque

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

4704318920 Issued in MI

Practice address

1665 W M 32
Gaylord, MI 49735-9287

Phone

(231) 535-2822

NPI assigned

Jul 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1982275194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 W M 32",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359287",
            "telephone_number": "231-535-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 W M 32",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359287",
            "telephone_number": "231-535-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUE",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "4704318920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Otsego Physician Services PC
• Jeremy D Otto, PHARM.D.
• Thomas Overett
• Genevieve L Owens, BEHAVIOR TECHNICIAN
• Samantha Rene' Packard, LMT
• Tabitha Carolin Pardo, FNP-C
• Patricia Duley MDPC
• Kathleen Marie Pawlanta, F.N.P.
• Alexis Payne, MD
• Dan Payne, PTA

• Addiction (Substance Use Disorder) Registered Nurse in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.