Individual
JACELYN M FATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2136 W. M-32, GAYLORD, MI 49735-9282
(989) 732-1791
(989) 732-7052
Mailing address
2136 W. M-32, GAYLORD, MI 49735-9282
(989) 732-1791
(989) 732-7052
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704282645
MI
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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