Individual
JACKIE LYNN MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, COHN-S, CAOHC
Contact information
Practice address
11937 HWY 271, TYLER, TX 75708-3154
(903) 877-5553
Mailing address
11937 HWY 271, TYLER, TX 75708-3154
(903) 877-5553
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
660165
TX
163WX0106X
Occupational Health Registered Nurse
Primary
660165
TX
246Z00000X
Other Specialist/Technologist
40275
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40275
CAOHC
—
01
—
660165
RN
TX
01
—
8922
COHN-S
—
Enumeration date
05/30/2013
Last updated
05/30/2013
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