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1275028896
JACLYN GROGAN STOUT
NEW YORK, NY
NPI
1275028896
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY 342661)
Enumeration Date
2018-06-26
Last Update Date
2018-06-26
Business Address
JACLYN GROGAN STOUT FNP
1275 YORK AVE
NEW YORK, NY 10065-6007
Phone number: 212-639-6987
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Mailing Address
JACLYN GROGAN STOUT FNP
303 E 60TH ST APT 19F
NEW YORK, NY 10022-1520
Phone number: 908-216-3706
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