Jesse Revin Situmeang, - Licensed Vocational Nurse in 29 Palms, CA

Jesse Revin Situmeang, is a Licensed Vocational Nurse based in 29 Palms, California. Jesse Revin Situmeang is licensed to practice in California (license number 243146) and his current practice location is 71952 Buena Vista Dr, 29 Palms, California. He can be reached at his office (for appointments etc.) via phone at (720) 666-0999.

NPI number for Jesse Revin Situmeang is 1164166492 and his current mailing address is 71952 Buena Vista Dr, 29 Palms, California. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1164166492.

Contact Information

Jesse Revin Situmeang,
71952 Buena Vista Dr,
29 Palms, CA 92277-2076
(720) 666-0999
(760) 401-8212



Provider's Profile

Full NameJesse Revin Situmeang
GenderMale
SpecialityLicensed Vocational Nurse
Location71952 Buena Vista Dr, 29 Palms, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1164166492
  • Provider Enumeration Date: 04/22/2022
  • Last Update Date: 04/22/2022

Medical Identifiers

Medical identifiers for Jesse Revin Situmeang such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164166492NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
164X00000XLicensed Vocational Nurse 243146 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jesse Revin Situmeang is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jesse Revin Situmeang,
71952 Buena Vista Dr,
29 Palms, CA 92277-2076

Ph: (720) 666-0999
Jesse Revin Situmeang,
71952 Buena Vista Dr,
29 Palms, CA 92277-2076

Ph: (720) 666-0999

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Licensed Vocational Nurse Nurses in 29 Palms, CA


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