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Individual

MRS. JACQUELINE TUCKER CARDENAS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MSN, RN, FNP-C

Contact information

Practice address
7201 US HIGHWAY 64 E, KNIGHTDALE, NC 27545-9268
(919) 266-7600
Mailing address
317 COLLINSWORTH DR, CLAYTON, NC 27527-3936
(919) 553-7646
(919) 553-7646

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201741
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0375652
ANCC FNP ID
01
51349
RN LICENSE
NC
01
NC201741
NC MEDICAL BOARD LICENSE
NC
Enumeration date
01/06/2006
Last updated
07/08/2007
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