Jaclyn N Edwers, RN

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

License

26NR17234300 Issued in NJ

Practice address

179 Brighton Ave Apt 1
Perth Amboy, NJ 08861-4778

Phone

(732) 850-8631

NPI assigned

Jan 15, 2024

Last updated

Aug 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1285405670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 SMITH ST # 121",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614345",
            "telephone_number": "908-488-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 BRIGHTON AVE APT 1",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614778",
            "telephone_number": "732-850-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWERS",
        "first_name": "JACLYN",
        "middle_name": "N",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR17234300",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NJ",
            "license": "26NR17234300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health & Wellness Coach in Perth Amboy, NJ
• Providers in Perth Amboy, NJ by specialty
• Health & Wellness Coach in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.