Provider Demographics
NPI:1457655797
Name:BANDELL, JACLYN MARIE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:MARIE
Last Name:BANDELL
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2868
Mailing Address - Country:US
Mailing Address - Phone:828-257-4745
Mailing Address - Fax:
Practice Address - Street 1:7 MCDOWELL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4116
Practice Address - Country:US
Practice Address - Phone:828-257-4745
Practice Address - Fax:828-252-2168
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR178088163W00000X
GARN230719363LF0000X
NC5007968363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse