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Individual

JOCELYN J PERDEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
111 CLINTON ST, MAUMEE, OH 43537-2811
(734) 464-0887
(734) 402-0254
Mailing address
36115 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(734) 464-0887
(734) 402-0254

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-268844
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.07311
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000213037
ANTHEM
OH
01
01973
PARAMOUNT
OH
05
114719896
MI
05
2413070
OH
01
P00193327
RAILROAD MEDICARE
OH
Enumeration date
12/12/2005
Last updated
07/01/2025
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