Individual
JACLYN BURKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
329 N SALINA ST, SYRACUSE, NY 13203-1755
(315) 471-1564
Mailing address
2225 47TH ST, ASTORIA, NY 11105-1309
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402633-1
NY
Other
Enumeration date
10/08/2009
Last updated
08/30/2019
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