| NPI | 1194103879 |
|---|---|
| Former Name | JACKLYN BILLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307252) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00555500) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00555500) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00555500) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2020-02-27 |