Individual
JACLYN S RIEBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
82 MACK BAYOU LOOP, SANTA ROSA BEACH, FL 32459-2637
(850) 233-3376
(850) 522-8354
Mailing address
2505 HARRISON AVE, PANAMA CITY, FL 32405-4464
(850) 233-3376
(850) 522-8354
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002990
VA
363A00000X
Physician Assistant
Primary
9114843
FL
Other
Enumeration date
01/23/2006
Last updated
03/04/2026
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