Jacqueline Anderson

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

428827 Issued in NY

Practice address

668 E 84TH St
Brooklyn, NY 11236-3428

Phone

(718) 828-2666

NPI assigned

Jun 14, 2019

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 14, 2019.

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1154981900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 E 84TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 E 84TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363428",
            "telephone_number": "718-828-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "428827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Anderson, M.D.
• Gwendolen S. Anderson
• Heather Anderson, OTR
• Irvin Burton Anderson, MD
• Jacey Anderson
• Jacqueline Connell Anderson, LCSW
• Janelle Anderson, LMSW
• Jarrod Anderson
• Judith Lucy Anderson, MSCCC-SLP
• Karla Anderson

• All providers in Brooklyn, NY
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.