Individual
MRS. JACLYN NICOLE BLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A-C
Contact information
Practice address
200 ROUTE 98 W ST, 310, NUTTER FORT, WV 26301-4385
(302) 624-0980
(304) 624-0095
Mailing address
200 ROUTE 98 W ST, 310, NUTTER FORT, WV 26301-4385
(302) 624-0980
(304) 624-0095
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
01038
WV
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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