Jaclyn C Abrahall, FNP-C, CDCES
Nurse Practitioner, Family in Hauppauge, NY. Individual provider (NPI-1).
NPI number1972036333
StatusActive
Last updated in NPPESJan 6, 2023
Details
- NPI
- 1972036333
- Entity type
- Individual (NPI-1)
- Name
- Jaclyn C Abrahall
- Credential
- FNP-C, CDCES
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 4, 2017
- Certification date
- Jan 6, 2023
- Last updated
- Jan 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 343035 | NY | Yes |
| 163WD0400X | Registered Nurse, Diabetes Educator | 695786 | NY |
Practice location
200 Motor Pkwy Ste C-16Hauppauge, NY 11788-5114
Phone 631-638-4933
Mailing address
200 Motor Pkwy Ste C-16Hauppauge, NY 11788-5114
Phone 631-638-4933
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