Provider Demographics
NPI:1962287896
Name:FOLCARELLI, JACQUELYN MARIE (CD(DONA))
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:MARIE
Last Name:FOLCARELLI
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10607 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-4469
Mailing Address - Country:US
Mailing Address - Phone:586-668-1013
Mailing Address - Fax:
Practice Address - Street 1:10607 S 27TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-4469
Practice Address - Country:US
Practice Address - Phone:586-668-1013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14904374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula