JACKIE D SPROW (NPI# 1396202743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396202743 |
| Entity Type | Individual |
| Full Name | JACKIE D SPROW |
| Credential | CRNP |
| Practice Address |
1001 E 2nd St Coudersport PA 16915-8179 |
| Practice Telephone | 8142745320 |
| Mailing Telephone | 8142749300 |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP019776 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1001 E 2ND ST |
| City | COUDERSPORT |
| State | PA |
| Zip Code | 16915-8179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609868736 | Kathleen M Kerr | Physician Assistant | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2005-08-16 |
| 1205498458 | Nina Lelic Miller | Dentist | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2019-07-08 |
| 1831754308 | Garrett Michael Russell | Physician Assistant | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2019-05-09 |
| 1740742279 | Joshua Hoppe | Physical Therapist | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2019-04-03 |
| 1821505983 | Kristine N Ball | Advanced Practice Midwife | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2018-01-10 |
| 1245743103 | Patricia K Stegman | Physician Assistant | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2017-11-14 |
| 1033562707 | Jennifer Davis | Dietitian, Registered | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2016-07-19 |
| 1497108161 | Gena Rasmussen | Dietitian, Registered | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2016-07-19 |
| 1356794226 | Charles Cole Memorial Hospital | Otolaryngology | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2016-07-15 |
| 1609226281 | Stephanie Black | Specialist | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2016-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134396930 | Carla J Muirhead | Registered Nurse | 1001 East 2nd Street, Coudersport, PA 16915 | 2008-05-12 |
| 1396926374 | Jeremy T Reed | Otolaryngology | 1001 E 2nd St Ste C, Coudersport, PA 16915 | 2007-11-19 |
| 1437274768 | Lynn Meredith Cornish | Dentist | 303 E Maple Street, Coudersport, PA 16915 | 2007-03-19 |
| 1508911736 | William T Kelley | Emergency Medicine | 1000 East 2nd Street, Coudersport, PA 16915 | 2007-01-25 |
| 1568569168 | Peter C Ryan | Dentist | 438 East Second St, Coudersport, PA 16915 | 2006-09-19 |
| 1538193248 | Eagle Emergency Physicians LLC | Emergency Medicine | 1000 E Second St, Emergency Department, Coudersport, PA 16915 | 2006-07-10 |
| 1245294875 | Victor Douglas Brown | Dentist | 6 Niles Hill Road, Coudersport, PA 16915 | 2006-04-12 |
| 1316312234 | Cody William Greene | Physical Therapist | 1028 E. Second Street, Coudersport, PA 16915 | 2015-12-03 |
| 1770958696 | Rosanne Marie Pesock | Occupational Therapy Assistant | 1028 E. Second Street, Coudersport, PA 16915 | 2015-12-03 |
| 1043685977 | Trisha Marie Bauer | Occupational Therapy Assistant | 1028 E. Second Street, Coudersport, PA 16915 | 2015-12-03 |
| Find all providers in zip 16915 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235500406 | Victoria Copp | Nurse Practitioner | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2015-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912170 | Kaley Elizabeth Barrett | Nurse Practitioner | 418 Edgewood Dr, Lebanon, PA 17042-9109 | 2020-11-04 |
| 1891395406 | Eimy Aguilar | Nurse Practitioner | 18 Descartes Dr, Lancaster, PA 17603-8861 | 2020-11-01 |
| 1134729775 | Jacqueline A Ouma | Nurse Practitioner | 4530 Clairton Blvd, Pittsburgh, PA 15236-2112 | 2020-10-30 |
| 1932709912 | Sheri Lynn Tittelmayer | Nurse Practitioner | 1012 Rozel Ave, Southampton, PA 18966-4130 | 2020-10-28 |
| 1346849197 | Alexander F Talarico | Nurse Practitioner | 576 Broad St, Emmaus, PA 18049-3856 | 2020-10-22 |
| 1255930129 | Patrick A Foster | Nurse Practitioner | 3332 Eisenbrown Rd, Reading, PA 19605-1412 | 2020-10-22 |
| 1033718051 | Charlene Martin Wolfgang | Nurse Practitioner | 806 Megan Dr, Cranberry Twp, PA 16066-7422 | 2020-10-21 |
| 1750980728 | Jamie Simpson | Nurse Practitioner | 618 Rachelle Ct, Latrobe, PA 15650-4731 | 2020-10-21 |
| 1124627138 | Ashley G Dillard | Nurse Practitioner | 5447 Stanton Ave, Pittsburgh, PA 15206-2518 | 2020-10-21 |
| 1831798867 | Elena Khlobystova | Nurse Practitioner | 16 Carriage House Dr, Southampton, PA 18966-2225 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | COUDERSPORT |
| Zip Code | 16915 |
Please comment or provide details below to improve the information on JACKIE D SPROW.
| 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.