Provider Demographics
NPI:1003438102
Name:FINNEY, JACYLN
Entity Type:Individual
Prefix:
First Name:JACYLN
Middle Name:
Last Name:FINNEY
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 1:21306 STATE ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:TREMONT
Mailing Address - State:IL
Mailing Address - Zip Code:61568-9252
Mailing Address - Country:US
Mailing Address - Phone:309-925-5511
Mailing Address - Fax:
Practice Address - Street 1:21306 STATE ROUTE 9
Practice Address - Street 2:
Practice Address - City:TREMONT
Practice Address - State:IL
Practice Address - Zip Code:61568-9252
Practice Address - Country:US
Practice Address - Phone:309-925-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator