Individual
LARISSA ANN JACKLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2000 MARY ST, SUITE 2500, PITTSBURGH, PA 15203-2054
(412) 488-5705
(412) 488-5206
Mailing address
2000 MARY ST, SUITE 2500, PITTSBURGH, PA 15203-2054
(412) 488-5705
(412) 488-5206
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP014869
PA
Other
Enumeration date
06/05/2015
Last updated
06/05/2015
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