Individual provider · Type 1 NPI
Jacklyn Ezzeldin
Psychiatric/Mental Health Registered Nurse · Little Rock, AR
NPI number
1861143364
Active
Practice location
6601 W 12th St
Little Rock, AR 72204-1513
Mailing address
PO Box 251970
Little Rock, AR 72225-1970
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | R04563 (AR) |
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | R04563 (AR) |
| Psychiatric/Mental Health Registered Nurse Primary | 163WP0808X | R04563 (AR) |
Psychiatric/Mental Health Registered Nurse: Definition to come...
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About NPI 1861143364
Jacklyn Ezzeldin's National Provider Identifier is 1861143364, issued on Jan 16, 2022. The primary taxonomy on file is Psychiatric/Mental Health Registered Nurse (163WP0808X), and the practice location is in Little Rock, AR. The record was last updated on Jan 16, 2022.