Individual
JACLYN NICASIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1629 MEDICAL ARTS BLVD STE 120, ANDERSON, IN 46011-3454
(765) 298-4220
(765) 298-4942
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71016449A
IN
Other
Enumeration date
04/02/2025
Last updated
05/16/2025
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