Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 2925252 | FL |
NPI | 1013421478 |
---|---|
Provider Name | Marjorie Claudine Jadotte |
First Address | West Park, FL 33023-5648 |
Second Address | Oakland Park, FL 33311-1409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2017 |
Last Update Date | 21/11/2017 |