Jaclyn Nicole Gill, PA-C
Physician Assistant, Medical in Saint Louis, MO. Individual provider (NPI-1).
NPI number1366766735
StatusActive
Last updated in NPPESJul 19, 2013
Details
- NPI
- 1366766735
- Entity type
- Individual (NPI-1)
- Name
- Jaclyn Nicole Gill
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 15, 2010
- Last updated
- Jul 19, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | – | Yes |
| 207P00000X | Emergency Medicine | 2010008198 | MO |
Practice location
6400 Clayton RdSte 110
Saint Louis, MO 63117-1850
Phone 314-645-4434 · Fax 314-645-3801
Mailing address
6400 Clayton RdSte 110
Saint Louis, MO 63117-1850
Phone 314-645-4434 · Fax 314-645-3801
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