Individual
JACULIN KEROUAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
3501 N SCOTTSDALE RD STE 320, SCOTTSDALE, AZ 85251-5650
(480) 882-5740
Mailing address
3501 N SCOTTSDALE RD STE 320, SCOTTSDALE, AZ 85251-5650
(480) 882-5740
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP7409
AZ
Other
Enumeration date
10/24/2014
Last updated
09/30/2015
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