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Individual
JACQUELYN DONNELLY
Active
Individual
JACQUELYN DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
10658
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10350I6318
MEDICARE PTAN
TN
05
—
1512704
—
TN
01
—
4321835
BCBST
TN
Enumeration date
03/23/2007
Last updated
09/14/2012
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