Individual
JACKIE G DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
300 MERCER MILL RD, ELIZABETHTOWN, NC 28337
(910) 862-6900
(910) 872-6290
Mailing address
395 ELKTON RD, CLARKTON, NC 28433-8747
(910) 645-4933
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
139366
NC
Other
Enumeration date
12/22/2006
Last updated
07/08/2007
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