Gist-Tillman, Jacqueline D

Gist-Tillman, Jacqueline D is an individual health care provider with primary practice located at 510 Clermont Ave. Room 211, Brooklyn NY 11238. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Gist-Tillman, Jacqueline D can be contacted via phone (718) 857-4646.

Contact Information

Primary practice address
510 Clermont Ave. Room 211 Brooklyn NY 11238
Phone: (718) 857-4646
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 476472 New York

Profile Details

NPI number 1801154141
LBN Legal business name Gist-Tillman, Jacqueline D
Credentials REGISTERED NURSE
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2012
Last updated Apr 24th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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