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Search › Pennsylvania › 363L00000X

Nicole Jackowski

NPI 1528576618 · on the registry since 2018

Practice

Address
100 Wilson Road
Bentleyville, PA 15314
Phone
(724) 239-2390
Fax
(724) 239-2393
Organisation at this address
Centerville Clinics, Inc,
Centerville Clinics, Inc.
Centerville Clinics, Inc Blended Bentleyville
Inferred from a shared address, not stated in the registry.
Clinicians at this address
5

Registry record

Primary taxonomy
363L00000X
363L00000X
Also registered as
208D00000X
363LP2300X
363LS0200X
363LW0102X
Licence states on file
PA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2019-03-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania