Jacqueline B Staal, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP 9204631 Issued in FL

Practice address

8595 College Pkwy
Suite 250
Fort Myers, FL 33919-5191

Phone

(239) 481-9999

NPI assigned

Nov 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jacqueline.staal.p1@direct.ppswcf.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Planned Parenthood of Florida, Inc.

  • Complex Family Planning Physician
  • West Palm Beach, FL
  • NPI 1285898445
  NPD (past)
• Planned Parenthood of North Florida, Inc.

  • Obstetrics & Gynecology Physician
  • Gainesville, FL
  • NPI 1093154288
  NPD (past)
• Planned Parenthood of Southwest and Central Florida Inc

  • Ambulatory Family Planning Facility
  • Sarasota, FL
  • NPI 1023221546
  NPD (past)
• Planned Parenthood of Southwest and Central Florida Inc.

  • Gynecology Physician
  • Fort Myers, FL
  • NPI 1033482724
  NPD (past)

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324857600000",
    "number": "1073794574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8595 COLLEGE PKWY",
            "address_2": "SUITE 250",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195191",
            "telephone_number": "239-481-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8595 COLLEGE PKWY",
            "address_2": "SUITE 250",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195191",
            "telephone_number": "239-481-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAAL",
        "first_name": "JACQUELINE",
        "middle_name": "B",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2011-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN 9204631",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9204631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Homecia Carmen St. Clair, CNM
• Jeffrey St. Firmin, PA-C
• St. Johns Surgery Center, LLC
• Chaline St. Louis, LMT
• St. Mark'S Surgicenter, LLC
• Angelica Marie Stabile, APRN, FNP-BC
• Jason P Stabley, D.O.
• Stacey Heidler LLC
• Richard Stadulis
• Samantha Staffiere

• Family Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2011; 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.