Individual provider Active NPI

Jessica Doolen, NP-C

  • School Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1235201708
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Nurse PractitionerTaxonomy code 363LS0200X
License
APN000824 Issued in NV
Practice address
400 Palo Verde Dr
Henderson, NV 89015-6028
Phone
(702) 799-0508
Fax
(702) 700-0510
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Nurse Practitioner 363LS0200X APN000824 NV Primary

Addresses

Primary practice location

400 Palo Verde Dr
Henderson, NV 89015-6028

Mailing address

6637 Secluded Ave
Las Vegas, NV 89110-5155
Phone (702) 453-3757

Other identifiers 1

IdentifierTypeStateIssuer
100510379MedicaidNV

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN000824NVMDSchool Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235201708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6637 SECLUDED AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891105155",
            "telephone_number": "702-453-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PALO VERDE DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890156028",
            "telephone_number": "702-799-0508",
            "fax_number": "702-700-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLEN",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LS0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, School",
            "state": "NV",
            "license": "APN000824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510379",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.