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Stephen Alexander Jaqua
Student in an Organized Health Care Education/Training Program in Charlotte, North Carolina
NPI 1912585811

Stephen Alexander Jaqua is a Student in an Organized Health Care Education/Training Program based in Charlotte, NC. Stephen Alexander Jaqua practices in Charlotte, NC. The NPI Number for Stephen Alexander Jaqua is 1912585811 and holds a License No. (North Carolina).

The current practice location address for Stephen Alexander Jaqua is 1000 Blythe Blvd, Charlotte, NC and can be reached out via phone at 704-381-6806.

Location: 1000 Blythe Blvd, Charlotte, NC, 28203-5812
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912585811
Provider Name
Stephen Alexander Jaqua
Credential
Provider Entity Type
Individual
Gender
Male
Address
1000 Blythe Blvd, Charlotte, NC, 28203-5812
Phone Number
704-381-6806
Fax Number
Provider Enumeration Date
03/31/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1000 Blythe Blvd
City
Charlotte
State
North Carolina
Zip
28203-5812
Phone Number
704-381-6806
Fax Number
person
Provider Business Mailing Address Details
Address
1000 Blythe Blvd
City
Charlotte
State
North Carolina
Zip
28203-5812
Phone Number
704-381-6806
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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