Jaclyn Marie Stratton, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AG06190356 Issued in MI

Practice address

35 W Huron St Ste 400
Pontiac, MI 48342-2124

Phone

(877) 572-2582

NPI assigned

Aug 6, 2019

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

Other names 1

• Jaclyn Marie Micallef Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1194370296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BOUTELL DR",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391512",
            "telephone_number": "248-496-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W HURON ST STE 400",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422124",
            "telephone_number": "877-572-2582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRATTON",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "AG06190356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "MICALLEF",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Nicole Stewart, PA-C
• Tracy Stewart
• Alisa Stokes
• Philip Michael Stone, MD
• Kylie Strange, PA-C
• Sydney Madison Street, PA-C
• Stroke Team One
• Terraina Marie Stroman-Holloway
• Debra Ann Strong, BS
• Sharise Stroud

• Primary Care Nurse Practitioner in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.