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Mrs. Jackie Lea Maiville, LPN
Licensed Practical Nurse in Wyoming, Michigan
NPI 1265925390

Jackie Lea Maiville is a Licensed Practical Nurse based in Wyoming, MI. Jackie Lea Maiville practices in Wyoming, MI and has the professional credentials of LPN. The NPI Number for Jackie Lea Maiville is 1265925390 and holds a License No. 4703029307 (Michigan).

The current practice location address for Jackie Lea Maiville is 1853 R W Berends Dr Sw, Wyoming, MI and can be reached out via phone at 616-534-9300.

Location: 1853 R W Berends Dr Sw, Wyoming, MI, 49519-4955
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265925390
Provider Name
Jackie Lea Maiville
Credential
LPN
Provider Entity Type
Individual
Gender
Female
Address
1853 R W Berends Dr Sw, Wyoming, MI, 49519-4955
Phone Number
616-534-9300
Fax Number
Provider Enumeration Date
06/13/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4703029307 05 MI
institution
Provider Business Practice Location Address Details
Address
1853 R W Berends Dr Sw
City
Wyoming
State
Michigan
Zip
49519
Phone Number
616-534-9300
Fax Number
person
Provider Business Mailing Address Details
Address
1853 R W Berends Dr Sw
City
Wyoming
State
Michigan
Zip
49519
Phone Number
616-534-9300
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
4703029307 (Michigan)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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