Individual
JACLYN K TAVERNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, MSN
Contact information
Practice address
520 E KENDALL DR UNIT C, YORKVILLE, IL 60560-1956
(630) 385-2360
(630) 385-2934
Mailing address
50 S B B KING BLVD, MEMPHIS, TN 38103-2626
(901) 436-1381
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277.001828
IL
363LF0000X
Family Nurse Practitioner
209.007311
IL
Other
Enumeration date
11/04/2008
Last updated
04/26/2022
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