NOGGY DAVID JAEN


Address: 10152 Gooding Dr, Dallas, TX 75229-6254
Phone: 2146766069

NOGGY DAVID JAEN (NPI# 1457877151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457877151
Entity Type Individual
Full Name NOGGY DAVID JAEN
Credential FNP
Practice Address 10152 Gooding Dr
Dallas
TX 75229-6254
Practice Telephone 2146766069
Mailing Telephone 2146766069
Enumeration Date 2017-08-15
Last Update Date 2018-03-17
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363L00000X Nurse Practitioner AP134217 TX Physician Assistants & Advanced Practice Nursing Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
AP134217 TX Physician Assistants & Advanced Practice Nursing Providers
N 363LP2300X Nurse Practitioner
Specialization: Primary Care
AP134217 TX Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
115 W Collin St, Corsicana, TX 751105222 9036025009

Office Location

Street Address 10152 GOODING DR
City DALLAS
State TX
Zip Code 75229-6254

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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Competitor

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City DALLAS
Zip Code 75229

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Dataset Information

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.

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