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Individual
STACY JENCKS
Active
Individual
STACY JENCKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
24192
AK
Other
Enumeration date
09/18/2009
Last updated
09/18/2009
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