Individual
JACQUES JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
615 E 6TH ST, STE 106, CHARLOTTE, NC 28202-2918
(704) 453-1444
(704) 260-0037
Mailing address
5226 FIREBRICK LN SW, CONCORD, NC 28025-8807
(704) 260-0037
(704) 260-0037
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5007327
NC
363LF0000X
Family Nurse Practitioner
F0814732
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477955284
—
NC
Enumeration date
09/24/2014
Last updated
10/19/2017
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