Individual
JENNIFER LYNN ULICNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1342 BELMONT ST, BROCKTON, MA 02301-4436
(603) 320-5984
Mailing address
2215 CLOUD COVER LN, RALEIGH, NC 27614-6603
(603) 320-5984
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
263035
NC
367500000X
Certified Registered Nurse Anesthetist
RN229427
MA
Other
Enumeration date
05/14/2013
Last updated
10/13/2021
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