Individual
JACQUELINE SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, IBCLC
Contact information
Practice address
14040 N CAVE CREEK RD, PHOENIX, AZ 85022-6117
(602) 299-7475
(623) 806-8655
Mailing address
3002 N 70TH ST UNIT 209, SCOTTSDALE, AZ 85251-6339
(602) 299-7475
(623) 806-8655
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-87868
AZ
Other
Enumeration date
12/12/2023
Last updated
12/12/2023
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