| NPI | 1801880497 |
|---|---|
| Professional Name | JACQUELYN ELAINE SHADDIX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: GA RN128424) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2007-07-08 |