MS. DEBRA LYNN JACKLEY (NPI# 1104475482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104475482 |
Entity Type | Individual |
Full Name | MS. DEBRA LYNN JACKLEY |
Credential | ACNP |
Practice Address |
350 N Wilmot Rd Tucson AZ 85711-2602 |
Mailing Address |
9562 E 29th St Tucson AZ 85748-8102 |
Practice Telephone | 5208733077 |
Mailing Telephone | 5205768153 |
Enumeration Date | 2019-09-09 |
Last Update Date | 2019-09-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
137103 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
350 N WILMOT RD |
City | TUCSON |
State | AZ |
Zip Code | 85711-2602 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770586869 | Emergency Room Associates Limited | Emergency Medicine | 350 N Wilmot Rd, Tucson, AZ 85711 | 2005-05-23 |
1831707579 | Landon C Richardson | Nurse Practitioner | 350 N Wilmot Rd, Tucson, AZ 85711-2602 | 2020-07-20 |
1497380877 | Eric G Martinez | Technician, Other | 350 N Wilmot Rd, Tucson, AZ 85711-2602 | 2020-03-06 |
1427680131 | Spencer Judd | Registered Nurse | 350 N Wilmot Rd, Tucson, AZ 85711-2602 | 2020-02-10 |
1639720063 | Southern Arizona Laborists | Hospitalist | 350 N Wilmot Rd, Tucson, AZ 85711-2678 | 2019-09-26 |
1376102301 | Candice Cameron | Specialist/Technologist, Other | 350 N Wilmot Rd, Tucson, AZ 85711-2602 | 2019-06-12 |
1932662764 | Herbert R Britanico | Emergency Medicine | 350 N Wilmot Rd, Tucson, AZ 85711-2602 | 2019-04-09 |
1629557798 | Hospitalist Medicine Physicians of Arizona - Tucson, Inc. | Internal Medicine | 350 N Wilmot Rd, Tucson, AZ 85711-2602 | 2018-08-09 |
1134613938 | Michelle Ann Cambern | Registered Nurse | 350 N Wilmot Rd, Tucson, AZ 85711-2602 | 2018-06-15 |
1225539422 | Johnna Tanji | Audiologist-Hearing Aid Fitter | 350 N Wilmot Rd, Tucson, AZ 85711-2602 | 2018-02-22 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356959951 | Ridgeline Practice | Counselor | 4625 N Broadway, Suite 105, Tucson, AZ 85711 | 2020-07-20 |
1881229946 | Famiglia Amore II LLC | Assisted Living Facility | 632 N. Wilmot, Tucson, AZ 85711 | 2020-03-10 |
1992343362 | Laurie Anne Mcmahon | Family Medicine | 899 N. Wilmot, Building B, Tucson, AZ 85711 | 2019-12-17 |
1063060093 | Sharese Ann Bailey | Counselor | 300 S Craycroft Rd, Tucson, AZ 85711 | 2019-09-03 |
1467940015 | Jin Zhang | Ophthalmology | 655 N Alvernon Way Ste 204, Tucson, AZ 85711 | 2018-04-30 |
1447779525 | Catherine Butler Hobart | Pharmacist | 535 North Wilmont Road, Suite 101, Tucson, AZ 85711 | 2017-09-11 |
1689196420 | Cope Community Services, Inc. | Case Management | 924 N Alvernon Way, Tucson, AZ 85711 | 2017-07-13 |
1124561477 | Regina Maendler | Behavioral Analyst | 630 N. Craycroft Rd, Tucson, AZ 85711 | 2016-11-18 |
1881140184 | Elleda Linsmeyer | Speech-Language Pathologist | St. Joesph's Hosptial, 350 N. Wilmont Rd., Tucson, AZ 85711 | 2016-08-28 |
1962856260 | Csl-tucson, LLC | Assisted Living Facility | 1020 N. Woodland Avenue, Tucson, AZ 85711 | 2016-04-22 |
Find all providers in zip 85711 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083226989 | Hillary Lamar | Nurse Practitioner | 3500 N Sabino Canyon Rd Unit 59, Tucson, AZ 85750-6141 | 2020-08-21 |
1437614476 | Betty Jo Hensley | Nurse Practitioner | 1650 E Perimeter Way, Tucson, AZ 85706-6079 | 2019-02-04 |
1457830192 | Jeremiah Opiniano Ramirez-damilig | Nurse Practitioner | Southern Arizona Va Healthcare System 3601 S 6th Avenue, Tucson, AZ 85723-0001 | 2018-08-13 |
1750836219 | Brenda Mitchell | Nurse Practitioner | 3375 N Campbell Ave, Tucson, AZ 85719-2306 | 2016-08-24 |
1851637128 | Andrew Peckham | Nurse Practitioner | 5433 E 8th St, Tucson, AZ 85711-3108 | 2012-12-14 |
1215290267 | Francisco Javier Carrillo | Nurse Practitioner | 2990 N Swan Rd Ste 227, Tucson, AZ 85712-6025 | 2012-06-22 |
1851615710 | Independent First Assist Inc. | Nurse Practitioner | 10129 E Rio De Oro Dr, Tucson, AZ 85749-8117 | 2010-03-22 |
1104002633 | Laura Dawn Mcree | Nurse Practitioner | 5463 N Stonehouse Pl, Tucson, AZ 85750-9674 | 2008-01-15 |
1669673638 | Kristie Walker Fry | Nurse Practitioner | 445 N Silverbell Rd Ste 202, Tucson, AZ 85745-2686 | 2007-05-29 |
1972620318 | Aura Leaf Kaila Edmondson | Nurse Practitioner | 5390 E Erickson Dr, Tucson, AZ 85712 | 2007-03-22 |
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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.