Individual
JACQUELYN KAREN HARDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
30651 77 1/2 ST, COVERT, MI 49043-9522
(269) 206-1306
Mailing address
30651 77 1/2 ST, COVERT, MI 49043
(269) 206-1306
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703105715
MI
Other
Enumeration date
07/20/2010
Last updated
07/20/2010
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