Individual
JACLYNN A JACKUBOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 982-5864
Mailing address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704362045
MI
363LF0000X
Family Nurse Practitioner
209010632
IL
Other
Enumeration date
09/29/2013
Last updated
06/24/2024
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