Provider Demographics
NPI:1689488009
Name:PICKET PIN, JOLENE KATHERINE
Entity type:Individual
Prefix:
First Name:JOLENE
Middle Name:KATHERINE
Last Name:PICKET PIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:H13 TRAILERVILLE CT
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-3614
Mailing Address - Country:US
Mailing Address - Phone:308-299-8522
Mailing Address - Fax:
Practice Address - Street 1:H13 TRAILERVILLE CT
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-3614
Practice Address - Country:US
Practice Address - Phone:308-299-8522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No253Z00000XAgenciesIn Home Supportive Care
No376J00000XNursing Service Related ProvidersHomemaker