Provider Demographics
NPI:1467225227
Name:PEARY, JACLYN (RN)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:
Last Name:PEARY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SOUTH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VT
Mailing Address - Zip Code:05443-1231
Mailing Address - Country:US
Mailing Address - Phone:978-987-9616
Mailing Address - Fax:
Practice Address - Street 1:445 THAYER BEACH RD
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-6529
Practice Address - Country:US
Practice Address - Phone:802-598-0124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0151733163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health