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Individual

MISS JACLYN ELIZABETH CHRISTIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1215 W BALTIMORE PIKE STE 13, MEDIA, PA 19063-5540
(610) 565-1919
(610) 566-8971
Mailing address
1215 W BALTIMORE PIKE STE 13, MEDIA, PA 19063-5540
(610) 565-1919
(610) 566-8971

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP026268
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SP026268
PA STATE BOARD OF NURSING
PA
Enumeration date
09/23/2022
Last updated
09/23/2022
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