Jacqueline Marie Iannacone, PMHNP-BC, CARN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ01352900 Issued in NJ

Practice address

2640 Highway 70 BLDG 7a
Manasquan, NJ 08736-2609

Phone

(347) 302-3514

NPI assigned

Aug 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1316675531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 ATLANTIS AVE",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502068",
            "telephone_number": "347-302-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 HIGHWAY 70 BLDG 7A",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362609",
            "telephone_number": "347-302-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNACONE",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC, CARN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01352900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE - RESIDENT",
            "identifier": "26NJ01352900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iane Howe
• Arielle Hughes, PA-C
• Meaghan Hughes, LAC
• Margaret Hyde
• Corina M Ianculovici, APRN, AG-PCP
• Ronald Joseph Iannacone, DO
• Immediate Care and Family Medical Center LLC
• Marzena Incolla
• Kenneth G Indahl, DPM
• Erica A Infante-Neill, MS, LPC

• Psychiatric/Mental Health Nurse Practitioner in Manasquan, NJ
• Providers in Manasquan, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.