Individual
JACKLINE OTIENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
793 AVERY POND DR, FUQUAY VARINA, NC 27526-4520
(201) 377-8121
(201) 377-8121
Mailing address
793 AVERY POND DR, FUQUAY VARINA, NC 27526-4520
(201) 377-8121
(201) 377-8121
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5024407
NC
Other
Enumeration date
05/08/2026
Last updated
05/08/2026
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