MS. JAQUELINE DENNISE CARROLL (NPI# 1255805990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255805990 |
| Entity Type | Individual |
| Full Name | MS. JAQUELINE DENNISE CARROLL |
| Credential | CRNP |
| Practice Address |
1526 Lombard St Philadelphia PA 19146-1625 |
| Mailing Address |
830 Mercer St Philadelphia PA 19125-3519 |
| Practice Telephone | 2155465960 |
| Mailing Telephone | 9084726759 |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
SP019576 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1526 LOMBARD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19146-1625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558303982 | Geriatric & Medical Services Inc | Assisted Living Facility | 1526 Lombard St, Philadelphia, PA 19146-1625 | 2006-06-11 |
| 1457965808 | Alaina Meghan Noronha | Physician Assistant | 1526 Lombard St, Philadelphia, PA 19146-1625 | 2020-09-03 |
| 1417573403 | Brandon Henry Ly | Speech-Language Pathologist | 1526 Lombard St, Philadelphia, PA 19146-1625 | 2020-06-25 |
| 1487281358 | Jessica Decraene | Occupational Therapist | 1526 Lombard St, Philadelphia, PA 19146-1625 | 2020-03-23 |
| 1326674581 | Joshua Fuller | Physical Therapy Assistant | 1526 Lombard St, Philadelphia, PA 19146-1625 | 2020-03-19 |
| 1033754973 | Kelsey Topham | Occupational Therapist | 1526 Lombard St, Philadelphia, PA 19146-1625 | 2019-11-14 |
| 1326693102 | Tram Huynh Tran | Physical Therapist | 1526 Lombard St, Philadelphia, PA 19146-1625 | 2019-08-07 |
| 1083269385 | Kathleen Claire Mcgee | Physical Therapist | 1526 Lombard St, Philadelphia, PA 19146-1625 | 2019-08-05 |
| 1194381947 | Pai Participant 5 PC | Internal Medicine | 1526 Lombard St, Philadelphia, PA 19146-1625 | 2019-05-17 |
| 1437616281 | Rachel Renee Koller | Physical Therapist | 1526 Lombard St, Philadelphia, PA 19146-1625 | 2019-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114545977 | Puentes De Salvd | Clinic/Center | 1700 South Street, Philadelphia, PA 19146 | 2020-07-08 |
| 1407480155 | Mutiat Ajibade | Nurse Practitioner | 1401 S. 31 Street, Phialdelphia, PA 19146 | 2020-03-02 |
| 1003453952 | Bridget Smith | Psychologist | Stratton Hall, 3201 Chestnut St., 2nd Floor, Philadelphia, PA 19146 | 2019-12-10 |
| 1730678012 | Christina Martindale | Nurse Anesthetist, Certified Registered | 917 S 15th Street, Philadelphia, PA 19146 | 2018-05-02 |
| 1598289456 | Allison Ortolano | Speech-Language Pathologist | 1933 Montrose St., Philadelphia, PA 19146 | 2017-08-01 |
| 1033630116 | Jami F Young | Psychologist | 2716 South Street, Behavioral Health 8/8473, Philadelphia, PA 19146 | 2017-06-29 |
| 1336678788 | Joshua Ryan Fidler | Occupational Therapist | 2223 Wharton Street, Philadelphia, PA 19146 | 2017-06-08 |
| 1912357930 | Mei Lan Natalie Lau | Pharmacist | 3000-02 Reed Street, Philadelphia, PA 19146 | 2016-06-21 |
| 1417354887 | Brandy Mitchell | Specialist | 1608 Webster Street, Philadelphia, PA 19146 | 2014-12-01 |
| 1942638101 | Woong Yi | Pharmacist | 1155 S.mole St, Philadelphia, PA 19146 | 2013-10-28 |
| Find all providers in zip 19146 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820622 | Diyong S Graham | Nurse Practitioner | 2812 Tremont St, Philadelphia, PA 19136-1025 | 2020-10-26 |
| 1750910808 | Alpha Integrated Clinic | Nurse Practitioner | 8019 Frankford Ave Rear, Philadelphia, PA 19136-2786 | 2020-04-01 |
| 1427681394 | Hwayoung Kim | Nurse Practitioner | 315 New St Apt 403, Philadelphia, PA 19106-1135 | 2020-02-19 |
| 1205306545 | Vadim Selyukov | Nurse Practitioner | 8815 Germantown Ave Ste 16, Philadelphia, PA 19118-2722 | 2018-11-29 |
| 1619420940 | Bridget Mccoy | Nurse Practitioner | 4929 Cedar Ave, Philadelphia, PA 19143-2013 | 2016-08-03 |
| 1003265489 | Stephanie Hand | Nurse Practitioner | 2409 Bainbridge St, Philadelphia, PA 19146-1014 | 2016-06-07 |
| 1679929095 | Michelle Marowitz | Nurse Practitioner | 3401 Civic Center Blvd Fl 11, Philadelphia, PA 19104 | 2016-05-05 |
| 1366834855 | Mary Morris | Nurse Practitioner | 1538 S 56th St, Philadelphia, PA 19143-4737 | 2015-02-20 |
| 1174920086 | Frances Garbarino | Nurse Practitioner | 501 S 53rd St, Philadelphia, PA 19143 | 2014-11-21 |
| 1033551130 | Mollie Evelyn Wilson | Nurse Practitioner | 5820 W Girard Ave, Philadelphia, PA 19131-4850 | 2013-07-18 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19146 |
Please comment or provide details below to improve the information on MS. JAQUELINE DENNISE CARROLL.
| 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.