Active NPI
Jaclyn Ariel Tully, CRNP
- Adult Health Nurse Practitioner
- Phoenixville, PA
National Provider Identifier
1124547898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- SP017799
- Practice address
- 143 Church St
Phoenixville, PA 19460-3438 - Phone
- (610) 935-1134
- NPI assigned
- Sep 14, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | SP017799 | PA | Primary |
Addresses
Primary practice location
143 Church St
Phoenixville, PA 19460-3438
Mailing address
143 Church St
Phoenixville, PA 19460-3438
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP017799 | PA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505347200000",
"number": "1124547898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 CHURCH ST",
"city": "PHOENIXVILLE",
"state": "PA",
"postal_code": "194603438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 CHURCH ST",
"city": "PHOENIXVILLE",
"state": "PA",
"postal_code": "194603438",
"telephone_number": "610-935-1134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLY",
"first_name": "JACLYN",
"middle_name": "ARIEL",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-14",
"last_updated": "2017-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "PA",
"license": "SP017799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenixville, PA
- Tricounty Chiropracticand Rehabilitation of Phoenixville PLLC
- Tricounty Medical Equipment and Supply, LLC
- Troy Oracko DMD PLLC
- Tony Wen-Fu Tsai, M.D.
- Pochau Anne Tsoi, MD
- Rajendra Tummala
- Valley Forge Facial Plastic Surgery ENT
- Valley Forge Family Chiropractic
- Valley Forge OB/GYN Division
- Valley Forge Surgical
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.