Individual
MRS. JACLYN JEANAI PETTIGREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1008 MOUNT ZION RD, UNION CITY, TN 38261-7694
(731) 885-8722
Mailing address
1008 MOUNT ZION RD, UNION CITY, TN 38261-7694
(731) 885-8722
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
95995
TN
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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