| NPI | 1588455968 |
|---|---|
| Former Legal Business Name | MARY JACQUELINE-FNP-C-PC |
| Former Legal Business Name | MARY JACQUELINE FNP-C-PC |
| Entity Type | Organization |
| Authorized Contact | YVETTE PARADEZA Office Manager 928-726-6772 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-05-14 |