Provider Demographics
NPI:1821385204
Name:NEMEC, JACQUELINE EVE (MD)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:EVE
Last Name:NEMEC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 MILLERS LANE
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-1008
Mailing Address - Country:US
Mailing Address - Phone:610-896-6836
Mailing Address - Fax:
Practice Address - Street 1:406 MILLERS LANE
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-1008
Practice Address - Country:US
Practice Address - Phone:610-896-6836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD007697E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry