Jeanine Noriko Packham, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

200150101NP Issued in OR

Practice address

1000 Locust St
Reno, NV 89502-2597

Phone

(775) 786-7200

NPI assigned

Jun 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1124054705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10584",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895100584",
            "telephone_number": "775-786-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LOCUST ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022597",
            "telephone_number": "775-786-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKHAM",
        "first_name": "JEANINE",
        "middle_name": "NORIKO",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "200150101NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Behavioral Health
• Pacific Medical, Inc. (Pacific Medical Prosthetics & Orthotics)
• Pack Pediatrics LLC
• Antonicia Antoinna Packard
• Lonnie Packard
• Tammy Packmore
• Pacrav Physical Therapy
• Tanja Irmgard Pacyao
• Brittney Paden, RN
• Emily Marie Paden

• Acute Care Nurse Practitioner in Reno, NV
• Providers in Reno, NV by specialty
• Acute Care Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.