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Individual

MRS. JACQUELIN N VICTORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 847-4100
Mailing address
1419 DOCTOR BLAIR RD, MARSHVILLE, NC 28103-9706
(704) 201-4230

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
262101
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
6646
NC

Other

Enumeration date
08/06/2020
Last updated
06/01/2021
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