Jennifer Pack, Nurse Practitioner, Apc

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

11906 Issued in CA

Legal business name

JENNIFER PACK, NURSE PRACTITIONER, APC

Practice address

15706 Pomerado Rd
Suite S 206
Poway, CA 92064-2067

Phone

(858) 485-8022

Fax

(858) 815-6820

NPI assigned

Mar 8, 2010

Last updated

Mar 8, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Lynn Pack, NP

Title

President

Phone

(858) 485-8022

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1043533870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15706 POMERADO RD",
            "address_2": "SUITE S 206",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642067",
            "telephone_number": "858-485-8022",
            "fax_number": "858-815-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15706 POMERADO RD",
            "address_2": "SUITE S 206",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642067",
            "telephone_number": "858-485-8022",
            "fax_number": "858-815-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER PACK, NURSE PRACTITIONER, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-08",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-485-8022",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "11906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark Denniel Macabuag Javier
• Helena Jayasuriya, L.C.S.W.
• Jami Jennings, MA, PPS CREDENTIAL
• Tamrah Jennings, FNP-C
• Jenny Raz Licensed Clinical Social Worker
• Jill Cottel MD, in. (Poway Integrative Medicine Center)
• Jill D. Paisley, Professional Chiropractic Corporation

• Acute Care Nurse Practitioner in Poway, CA
• Providers in Poway, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.