Individual
MS. JACQUELINE ANN BRAZIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
3390 COUNTRY VILLAGE RD APT 2217, RIVERSIDE, CA 92509-1084
(951) 403-8879
Mailing address
PO BOX 3591, RIVERSIDE, CA 92519-3591
(951) 403-8879
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
464833
CA
Other
Enumeration date
01/11/2014
Last updated
01/11/2014
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