Individual
JACLYN NORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3521
Mailing address
22 E LUZERNE AVE, LARKSVILLE, PA 18704-1025
(570) 718-7065
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN612142
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001297888
VIRGINIA STATE BOARD OF NURSING
VA
01
—
RN612142
PENNSYLVANIA STATE BOARD OF NURSING
PA
Enumeration date
01/13/2023
Last updated
01/13/2023
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