Individual
JACQUELINE USTACHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
15311 CORTEZ BLVD, BROOKSVILLE, FL 34613-6005
(352) 540-9335
Mailing address
15311 CORTEZ BLVD, BROOKSVILLE, FL 34613-6005
(352) 540-9335
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
APRN9276314
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN-175606
MT
Other
Enumeration date
05/24/2016
Last updated
03/01/2025
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