Jacquelyn Rae Forsythe, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

1718622 Issued in FL

Practice address

3033 Winkler Avenue Ext
Fort Myers, FL 33916-9413

Phone

(239) 939-3939

NPI assigned

Sep 26, 2006

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

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.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366543266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9061 SW LIPE RD",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342696605",
            "telephone_number": "863-494-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 WINKLER AVENUE EXT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169413",
            "telephone_number": "239-939-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSYTHE",
        "first_name": "JACQUELYN",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "1718622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Edwin Ford Jr., RPH
• Christine Arminda Fordham, M.D.
• Fiorella Forgey
• Brooke Lyall Foris, PSY.D.
• Ivian Forjans Perez
• Fort Myers Central Chiropractic LLC
• Fort Myers Centre for Facial Plastic and Laser Surgery, Inc.
• Fort Myers Children'S Surgery Center, LLC
• Fort Myers Chiropractic & Nutrition Center, Inc.
• Fort Myers Chiropractic Studio LLC

• Adult Health Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Adult Health Nurse Practitioner in Florida

• 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.