Provider Demographics
NPI:1023637766
Name:JBNP SERVICES, LLC
Entity type:Organization
Organization Name:JBNP SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JAAFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYDOUN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:734-658-9592
Mailing Address - Street 1:38221 PLYMOUTH RD STE 3
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1051
Mailing Address - Country:US
Mailing Address - Phone:734-221-0236
Mailing Address - Fax:734-293-4240
Practice Address - Street 1:38221 PLYMOUTH RD STE 3
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1051
Practice Address - Country:US
Practice Address - Phone:734-658-9592
Practice Address - Fax:734-293-4240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-13
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty