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Individual
NICOLE JACKOWSKI
Active
Individual
NICOLE JACKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
SP018536
PA
363L00000X
Nurse Practitioner
Primary
SP018536
PA
363LP2300X
Primary Care Nurse Practitioner
SP018536
PA
363LS0200X
School Nurse Practitioner
SP018536
PA
363LW0102X
Women's Health Nurse Practitioner
SP018536
PA
Other
Enumeration date
01/11/2018
Last updated
03/21/2019
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