Individual
JACLYN GALVEZ TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 BIESTERFIELD RD, ELK GROVE VILLAGE, IL 60007-3361
(570) 288-8969
Mailing address
1690 DUNLAWTON AVE, SUITE 130, PORT ORANGE, FL 32127-8979
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041347493
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209014099
IL
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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