Individual
JACLYN NICOLE DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 250-4800
Mailing address
7109 FARLEY RD, PINCKNEY, MI 48169-8545
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704295696
MI
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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