Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 4704206804 | MI |
N | 363LA2100X | Nurse Practitioner - Acute Care | 4704206804 | MI |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 4704206804 | MI |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 4704206804 | MI |
NPI | 1639259757 |
---|---|
Provider Name | Mrs. Jacqueline Felecia Metzger |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Jackson, MI 49201-2419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 22/10/2014 |