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Individual
MRS. KELLY MICHELLE JACCHIA
Active
Individual
MRS. KELLY MICHELLE JACCHIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN138990
GA
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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