Provider Demographics
NPI:1437988565
Name:SANCHEZ, JACKELIN O
Entity type:Individual
Prefix:
First Name:JACKELIN
Middle Name:O
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6163
Mailing Address - Country:US
Mailing Address - Phone:301-433-1259
Mailing Address - Fax:
Practice Address - Street 1:645 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6163
Practice Address - Country:US
Practice Address - Phone:570-484-2704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program