Individual
JACKLYN LOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2525 FOX RUN PKWY, SUITE 101, YANKTON, SD 57078-5370
(605) 665-0062
Mailing address
2525 FOX RUN PKWY, SUITE 101, YANKTON, SD 57078-5370
(605) 665-0062
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
111973
NE
363L00000X
Nurse Practitioner
Primary
CP001028
SD
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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