Booker, Jacqulyne S

Booker, Jacqulyne S is an individual health care provider with primary practice located at 995 S Clarizz Blvd , Bloomington IN 47401-5588. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Booker, Jacqulyne S can be contacted via phone (812) 353-3060.

Contact Information

Primary practice address
995 S Clarizz Blvd Bloomington IN 47401-5588
Phone: (812) 353-3060
Fax: (812) 353-3070
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71001863 Indiana

Profile Details

NPI number 1316991557
LBN Legal business name Booker, Jacqulyne S
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Dec 2nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316991557 NPPES
Indiana Other 71001863 INDIANA NURSE PRACTITIONE
Indiana Other 28085357A INDIANA NURSE PRACTITIONE

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