Individual
JACQUELYNE BETH GIFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
383 COUNTY ROAD 1183, NOVA, OH 44859-9745
(419) 652-2570
Mailing address
383 COUNTY ROAD 1183, NOVA, OH 44859-9745
(419) 652-2570
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 030761
OH
Other
Enumeration date
07/06/2007
Last updated
07/08/2007
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