Jacqueline Ann Carrillo CFNP

NPI 1346460078 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1346460078
Gender Female
Enumeration Date 04/26/2007
Last Updated 04/10/2014
Entity Type Individual
Active Over 9 years ago
Practice Location
2500 N STATE ST
JACKSON MS, 39216-4500, US
Phone (601) 984-5610
Fax (601) 984-5783
Business Location
2500 N STATE ST
DIVISION OF GERIATRICS
JACKSON MS, 39216-4500, US
Phone (601) 984-5610
Fax (601) 984-5783
Toxanomy
Taxonomy Code 363LF0000X
License State Mississippi
License Number R752134
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According to our database, Mrs. Jacqueline Ann Carrillo CFNP NPI is 1346460078, taxonomy code is 363LF0000X and license number is R752134, license state is located at Mississippi. Jacqueline Ann Carrillo CFNP physically located at 2500 N State St, Jackson MS, 39216-4500. NPI Number Jacqueline Ann Carrillo CFNP has the Individual type.

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1346460078 NPI number is provided on an as is basis without warranty of any kind. 1346460078 is maintained by the National Plan & Provider Enumeration System. The contents of Jacqueline Ann Carrillo CFNP are for informational purposes only.