| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JACQUELINE FUNK | 1104689793 | 2024-06-09 |
Jacqueline Funk is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1104689793. Registration indicates Jacqueline Funk is a provider of services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant (Physician Assistant: Surgical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Surgical Technologist, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, )
| Entity Type | Individual |
| Provider Name | Jacqueline Funk |
| Practice Office Address | 8230 WALNUT HILL BUILDING 3 SUITE 320 DALLAS, TX US |
| Practice Office Telephone | 2143695432 |
| Practice Office Fax | 2143695591 |
| Mailing Address | 8230 WALNUT HILL BUILDING 3 SUITE 320 DALLAS, TX 75231 US |
| Business Telephone | 2143695432 |
| Business Fax | 2143695591 |
| Direct Messaging Address [] | [email protected] | Health Information Exchange (HIE) |
| Code | Practice | License No State |
|---|---|---|
| 363AS0400X PRIMARY | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Surgical All Other Specialties & Provider Types Physician Assistant Surgical Technologist Physician Assistants & Advanced Practice Nursing Providers Physician Assistant |