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Individual
JACLYN THERESA CHANNELL
Active
Individual
JACLYN THERESA CHANNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
792582
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP145190
TX
363LG0600X
Gerontology Nurse Practitioner
AP145190
TX
Other
Enumeration date
02/20/2020
Last updated
03/26/2024
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