JACKELIN SMITH (NPI# 1083175871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083175871 |
| Entity Type | Individual |
| Full Name | JACKELIN SMITH |
| Credential | ARNP |
| Practice Address |
10685 Essex Square Blvd Fort Myers FL 33913-2612 |
| Practice Telephone | 7863902650 |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-03-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
11001833 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10685 ESSEX SQUARE BLVD |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33913-2612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467079368 | Fq0014 | Clinic/Center | 11930 Fairway Lakes Dr, Ste 103, Fort Myers, FL 33913 | 2020-06-26 |
| 1386272334 | Chrysallis Wellness Center Inc | Counselor | 11932 Faiway Lakes, Fort Myers, FL 33913 | 2020-03-27 |
| 1811459399 | Kelly Christine Reynolds | Student in an Organized Health Care Education/Training Program | 11750 Rosemount Drive, Fort Myers, FL 33913 | 2019-04-03 |
| 1043784432 | Alex Richard Reynolds | Physician Assistant | 2700 Creekside Ln, Suit 101, Fort Myers, FL 33913 | 2019-01-18 |
| 1881196541 | Kara Seanor | Counselor | 12575 Stone Tower Loop, Fort Myers, FL 33913 | 2018-03-08 |
| 1063951515 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 13121 Paul J. Doherty Pkwy, Fort Myers, FL 33913 | 2017-02-16 |
| 1518337492 | Barry K Butler P.a. | Internal Medicine | 10708 Bradbury Way, Fort Myers, FL 33913 | 2015-10-05 |
| 1811322886 | Bernard Timothy Renner | Pharmacist | 10000 Gulf Coast Town Center Drive, Ft. Myers, FL 33913 | 2013-09-10 |
| 1831531979 | Debra Anne Channer | Pharmacist | 12550 Professional Park Drive Unit 1, Walgreens Co., Ft. Myers, FL 33913 | 2013-07-17 |
| 1144572249 | Victoria Sydeco Tayengco-maisog | Pediatrics | 9304 Trieste Drive, Fort Myers, FL 33913 | 2012-10-12 |
| Find all providers in zip 33913 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384154 | Melissa Connors | Nurse Practitioner | 15609 Fiddlesticks Blvd, Fort Myers, FL 33912-3902 | 2020-10-18 |
| 1982202412 | Amanda Shively | Nurse Practitioner | 7951 Reflection Cove Dr Apt 102, Fort Myers, FL 33907-6560 | 2020-10-16 |
| 1205433828 | Kenneth Midoneck | Nurse Practitioner | 4445 Kings Barn Ct Unit 305, Fort Myers, FL 33916-8031 | 2020-10-06 |
| 1881218246 | Miraleen Patel | Nurse Practitioner | 5710 Trailwinds Dr Apt 524, Fort Myers, FL 33907-8338 | 2020-06-02 |
| 1194350348 | Zuleima Lozada | Nurse Practitioner | 13691 Metro Pkwy Ste 110a, Fort Myers, FL 33912-4348 | 2020-03-09 |
| 1962034686 | Kathleen A Shelton | Nurse Practitioner | 9371 Cypress Lake Dr Ste 16, Fort Myers, FL 33919-4945 | 2020-02-11 |
| 1275173155 | Optimal Healing Healthcare Services, LLC | Nurse Practitioner | 10143 Chesapeake Bay Dr, Fort Myers, FL 33913-9184 | 2020-01-08 |
| 1033760731 | Jaclyn Mason | Nurse Practitioner | 18431 Hawthorne Rd, Fort Myers, FL 33967-3276 | 2019-09-24 |
| 1245894419 | Sonya Brielle Hayhurst | Nurse Practitioner | 16026 Via Solera Cir Apt 102, Fort Myers, FL 33908-7706 | 2019-04-23 |
| 1124584818 | Anisley Robaina | Nurse Practitioner | 13685 Doctors Way Ste 170, Fort Myers, FL 33912-4337 | 2019-02-18 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33913 |
Please comment or provide details below to improve the information on JACKELIN SMITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.