Provider Demographics
NPI:1790436285
Name:DAY, JACOLYN (FNP)
Entity Type:Individual
Prefix:
First Name:JACOLYN
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3747 COLE AVE APT 231
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1584
Mailing Address - Country:US
Mailing Address - Phone:214-548-1726
Mailing Address - Fax:
Practice Address - Street 1:3747 COLE AVE APT 231
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-1584
Practice Address - Country:US
Practice Address - Phone:214-548-1726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-16
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX900055363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner