Jacqueline Boreland, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN141662 Issued in GA

Practice address

390 Riverbirch LN
Lawrenceville, GA 30044-4558

Phone

(678) 376-2565

Fax

(678) 376-2307

NPI assigned

Mar 24, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Jacqueline Jackson-Boreland Professional name

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1376937672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 RIVERBIRCH LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444558",
            "telephone_number": "678-376-2565",
            "fax_number": "678-376-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 RIVERBIRCH LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444558",
            "telephone_number": "678-376-2565",
            "fax_number": "678-376-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORELAND",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN141662",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "R49833",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "22445006",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "JACKSON-BORELAND",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Megan E Bonselaar, OTR/L
• Rebecca Anne Booker, PMHNP
• Shalanda Monique Booker
• Shirley Boone-Sanford, PH.D.
• Boostcare LLC
• Ashley Attaway Born
• Angela Bostic-Maddox
• Scott G Boswell
• John David Botero, NP-C
• Manuela Botero

• Registered Nurse in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.