Individual
DEBRA C JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
832 W CENTRAL BLVD, ORLANDO, FL 32805-1809
(407) 760-0195
(407) 482-4486
Mailing address
832 W CENTRAL BLVD, ORLANDO, FL 32805-1809
(407) 760-0195
(407) 482-4486
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN3224602
FL
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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