Denise Jacks ARNP

NPI 1104136738 - Nurse Practitioner - 363LA2200X

NPI Details
NPI 1104136738
Gender Female
Enumeration Date 10/17/2010
Last Updated 07/30/2014
Entity Type Individual
Active Over 6 years ago
Practice Location
1301 2ND AVE SW
LARGO FL, 33770-3120, US
Phone (727) 581-8767
Fax (727) 581-3727
Business Location
1301 2ND AVE SW
LARGO FL, 33770-3120, US
Phone (727) 581-8767
Fax (727) 581-3727
Toxanomy
Taxonomy Code 363LA2200X
License State Florida
License Number 3017972
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According to our database, Denise Jacks ARNP NPI is 1104136738, taxonomy code is 363LA2200X and license number is 3017972, license state is located at Florida. Denise Jacks ARNP physically located at 1301 2nd Ave Sw, Largo FL, 33770-3120. NPI Number Denise Jacks ARNP has the Individual type.

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1104136738 NPI number is provided on an as is basis without warranty of any kind. 1104136738 is maintained by the National Plan & Provider Enumeration System. The contents of Denise Jacks ARNP are for informational purposes only.