Individual
JACQUELYN RAWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
7210338
MA
363LF0000X
Family Nurse Practitioner
Primary
7210338
MA
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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