Provider Demographics
NPI:1386397073
Name:DEAN, JACQUEL (RN)
Entity type:Individual
Prefix:MRS
First Name:JACQUEL
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9706 CHIPSTEAD CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6593
Mailing Address - Country:US
Mailing Address - Phone:334-750-8289
Mailing Address - Fax:
Practice Address - Street 1:9706 CHIPSTEAD CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6593
Practice Address - Country:US
Practice Address - Phone:334-738-4269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX988104363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health