Individual
LISE JEAN JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
740 NE 130TH ST, NORTH MIAMI, FL 33161-7527
(786) 241-1274
Mailing address
765 WHIPPOORWILL ROW, WEST PALM BEACH, FL 33411-5231
(786) 241-1274
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
9413465
FL
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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