Provider Demographics
NPI:1841659950
Name:ARMSTRONG, JAECELYN
Entity type:Individual
Prefix:
First Name:JAECELYN
Middle Name:
Last Name:ARMSTRONG
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 1:18665 MIDWAY RD
Mailing Address - Street 2:APT. 321
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-3978
Mailing Address - Country:US
Mailing Address - Phone:601-988-3324
Mailing Address - Fax:
Practice Address - Street 1:18665 MIDWAY RD
Practice Address - Street 2:APT. 321
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-3978
Practice Address - Country:US
Practice Address - Phone:601-988-3324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other