| NPI | 1760718530 |
|---|---|
| Former Name | JANE E JACKLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71000178A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71000178A) |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2018-06-27 |