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General NPI Number Information
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NPI Number | 1255300562
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Entity Type | Individual
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Provider Name | JACQUELINE D. RYCHNOVSKY PHD, RN, CPNP
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Gender | Female
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 34800 BOB WILSON DR NAVAL MEDICAL CENTER
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City | SAN DIEGO
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State | CA
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Zip | 92134-1098
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Country | US
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Telephone | 619-532-8234
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Fax | 619-532-8137
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Provider Business Mailing Address
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Address Line | 1848 LAGRANGE ROAD
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City | CHULA VISTA
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State | CA
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Zip | 91913-1680
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Country | US
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Telephone | 619-889-8545
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Fax | 619-934-4760
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 12380
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License Number State | CA
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