Terwilliger, Jacqueline Renee

Terwilliger, Jacqueline Renee is an individual health care provider with primary practice located at 303 N Clyde Morris Blvd , Daytona Beach FL 32114-2709. 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. Terwilliger, Jacqueline Renee can be contacted via phone (386) 254-4000.

Contact Information

Primary practice address
303 N Clyde Morris Blvd Daytona Beach FL 32114-2709
Phone: (386) 254-4000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP 1757372 Florida

Profile Details

NPI number 1790745909
LBN Legal business name Terwilliger, Jacqueline Renee
Credentials ARNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Dec 2nd, 2016 - about 9 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 1790745909 NPPES
Florida MEDICAID 308261000

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