Individual
KATELYN KEITH JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP A-GNP
Contact information
Practice address
407 CRUTCHFIELD ST, DURHAM, NC 27704-2726
(919) 660-2324
Mailing address
3560 MOUNT HERMON ROCK CRK RD, GRAHAM, NC 27253-9712
(704) 776-2777
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
KEIT-Y8EZ5
NC
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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