Wooley, Jaclyn Michelle

Wooley, Jaclyn Michelle is an individual health care provider with primary practice located at 3 Pine Cone Dr Ste 102 , Palm Coast FL 32137-8684. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Wooley, Jaclyn Michelle can be contacted via phone (386) 864-6005.

Contact Information

Primary practice address
3 Pine Cone Dr Ste 102 Palm Coast FL 32137-8684
Phone: (386) 864-6005
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9104571 Florida

Profile Details

NPI number 1124299524
LBN Legal business name Wooley, Jaclyn Michelle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 13th, 2008
Last updated Jul 3rd, 2019 - about 6 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 1124299524 NPPES
Florida Other 1081244 NCCPA CERTIFICATION

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