Individual
JACLYN MACKENZIE LITTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5981 FAR HILLS AVE, DAYTON, OH 45429-2211
(937) 438-5954
Mailing address
5981 FAR HILLS AVE, DAYTON, OH 45429-2211
(937) 438-5954
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.0035150
OH
Other
Enumeration date
10/13/2023
Last updated
12/19/2023
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