| NPI | 1073826764 |
|---|---|
| Former Name | JACLYN THERESA MCBRIDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0999203) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 194930) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2023-10-06 |