Provider Demographics
NPI:1649543612
Name:SEMEXANT, JENNIE (LPN)
Entity type:Individual
Prefix:MS
First Name:JENNIE
Middle Name:
Last Name:SEMEXANT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 EASTERN PARKWARY
Mailing Address - Street 2:APT#2I
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-1411
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:436 EASTERN PKWY
Practice Address - Street 2:APT#2I
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-1447
Practice Address - Country:US
Practice Address - Phone:347-564-8062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305629-1164W00000X
NY684209-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse