Individual
MS. JACLYN PRIMAVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 COOPER PLZ, CAMDEN, NJ 08103-1461
(856) 342-2000
Mailing address
59 ELFRETH RD, HUNTINGDON VALLEY, PA 19006-1210
(215) 518-1832
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
138202
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
26NR21071400
NJ
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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