Individual
MISS JACQUELINE ELIZABETH NURSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
652 CANYON STONE CIR, LAKE MARY, FL 32746-3978
(772) 333-4298
Mailing address
652 CANYON STONE CIR, LAKE MARY, FL 32746-3978
(772) 333-4298
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP2784612
FL
Other
Enumeration date
04/01/2017
Last updated
04/01/2017
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