Michele D Jack, RN
Registered Nurse in Bradford, PA. Individual provider (NPI-1).
NPI number1033314331
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1033314331
- Entity type
- Individual (NPI-1)
- Name
- Michele D Jack
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 18, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | RN524462L | PA | Yes |
Practice location
20 School StBradford, PA 16701-1257
Phone 814-362-7466
Mailing address
17028 Route 6Smethport, PA 16749-4024
Phone 814-887-2229
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All 28 Registered Nurse providers in Bradford · All 439 providers in Bradford
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