Provider Demographics
NPI:1053876649
Name:ARMSTEAD, JACQUELINE (COMM HEALTH WORKER)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:ARMSTEAD
Suffix:
Gender:F
Credentials:COMM HEALTH WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11270 US HWY 19 N
Mailing Address - Street 2:BLDG#3 APT#108
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764
Mailing Address - Country:US
Mailing Address - Phone:727-303-5797
Mailing Address - Fax:
Practice Address - Street 1:11270 US HWY 19 N
Practice Address - Street 2:BLDG#3 APT#108
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764
Practice Address - Country:US
Practice Address - Phone:727-303-5797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374J00000XNursing Service Related ProvidersDoula