JACLYN BACON (NPI# 1265716344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265716344 |
| Entity Type | Individual |
| Full Name | JACLYN BACON |
| Credential | FNP-C |
| Practice Address |
10238 E Hampton Ave Suite 202 Mesa AZ 85209-3316 |
| Practice Telephone | 6235124390 |
| Practice Fax Number | 6235124391 |
| Mailing Telephone | 6235124390 |
| Mailing Fax Number | 6235124391 |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2013-03-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP4198 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10238 E HAMPTON AVE SUITE 202 |
| City | MESA |
| State | AZ |
| Zip Code | 85209-3316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861494551 | Santina Carminati Taddei | Internal Medicine | 10238 E Hampton Ave, Suite 305, Mesa, AZ 85209-3316 | 2005-08-11 |
| 1932749546 | Physician Group of Arizona Inc | Orthopaedic Surgery | 10238 E Hampton Ave, Suite 301-a, Mesa, AZ 85209-3322 | 2020-01-11 |
| 1154874790 | Carissa Noriega | Nurse Practitioner | 10238 E Hampton Ave, #507, Mesa, AZ 85209-3316 | 2016-08-01 |
| 1336500198 | Mountain Vista Medical Group Pllc | Specialist | 10238 E Hampton Ave, Suite 205, Mesa, AZ 85209 | 2016-03-08 |
| 1750789079 | Jasmine Turner | Nurse Practitioner | 10238 E Hampton Ave, 508, Mesa, AZ 85209-3316 | 2014-12-18 |
| 1881012144 | Arizona Hospital Specialists, Pllc | Family Medicine | 10238 E Hampton Ave, 205, Mesa, AZ 85209-3316 | 2014-04-03 |
| 1033543749 | Akdhc, LLC | Internal Medicine | 10238 E Hampton Ave, Suite 504, Mesa, AZ 85209-3316 | 2013-08-29 |
| 1134473838 | East Valley Medical Group, Inc. | General Practice | 10238 E Hampton Ave, Suite 212, Mesa, AZ 85209-3316 | 2012-11-01 |
| 1164775698 | Arizona Gastro Care | Internal Medicine | 10238 E Hampton Ave, #305, Mesa, AZ 85209-3316 | 2012-10-22 |
| 1477872786 | Michelle Leigh Pande | Nurse Practitioner | 10238 E Hampton Ave, Suite 202, Mesa, AZ 85209-3316 | 2010-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
| 1558916247 | Shiny Susan Thomas | Family Medicine | 7615,east Baseline Road, Mesa, AZ 85209 | 2019-08-08 |
| 1245798933 | Premier Care Medical Services Pllc | Clinic/Center | 7363 E Naranja Ave, Mesa, AZ 85209 | 2019-03-12 |
| 1518450568 | Mhb Services | Internal Medicine | 1301 S Crismon Road, Mesa, AZ 85209 | 2018-06-13 |
| 1174012934 | Andrew Swenson | Student in an Organized Health Care Education/Training Program | 10238 E. Hampton #406, Mesa, AZ 85209 | 2018-05-08 |
| 1689196057 | Monica R Meyer | Registered Nurse | 2424 S Rowen, Mesa, AZ 85209 | 2017-07-07 |
| 1629507041 | Rachel Ann Navarro | Occupational Therapist | 10431 E Natal Ave, Mesa, AZ 85209 | 2017-06-08 |
| 1073041331 | Michelle Resendez | Nurse Practitioner | 2500 S Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-31 |
| 1275069569 | Michelle Amado | Nurse Practitioner | 2500 S. Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-04 |
| 1982138079 | Warren Brent Thomas | Nurse Anesthetist, Certified Registered | 10632 E Kiva Ave, Mesa, AZ 85209 | 2017-04-14 |
| Find all providers in zip 85209 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053926410 | Matthew Derrick Miller | Nurse Practitioner | 9354 E Thatcher Cir, Mesa, AZ 85212-8539 | 2020-09-12 |
| 1750995858 | Hayley Madler | Nurse Practitioner | 1061 N Omaha Cir, Mesa, AZ 85205-5023 | 2020-09-04 |
| 1043823800 | Nancy Lynn Mitchell | Nurse Practitioner | 1535 N 26th St, Mesa, AZ 85213-4151 | 2020-08-30 |
| 1003429218 | Krista Ann Clevenger | Nurse Practitioner | 3155 E Southern Ave Ste 203, Mesa, AZ 85204-5521 | 2020-08-26 |
| 1093326290 | Joshua Jackson | Nurse Practitioner | 5432 E Southern Ave Ste 101b, Mesa, AZ 85206-2772 | 2020-08-11 |
| 1790395531 | Kelly C Banonis | Nurse Practitioner | 3322 N Brighton, Mesa, AZ 85207-0997 | 2020-08-06 |
| 1689284911 | Katie Keil | Nurse Practitioner | 1061 N Dobson Rd Ste 107, Mesa, AZ 85201-7576 | 2020-08-02 |
| 1831711670 | Saraswati Hamal | Nurse Practitioner | 4850 S Curie Way, Mesa, AZ 85212-9582 | 2020-05-14 |
| 1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
| 1659992436 | Elizabeth Erb | Nurse Practitioner | 1361 S Alma School Rd, Mesa, AZ 85210-2085 | 2020-05-02 |
| Find all providers in MESA | ||||
Please comment or provide details below to improve the information on JACLYN BACON.
| 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.