Jacqulyne Taylor, ARNP FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11011532 Issued in FL

Practice address

906 Palm Blvd S
Niceville, FL 32578-2603

Phone

(850) 517-9851

NPI assigned

Feb 9, 2021

Last updated

Jun 30, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7208/brand/2/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Niceville Urgent Care LLC

  • Urgent Care Clinic/Center
  • Niceville, FL
  • NPI 1881015477
  NPD

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1386236560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 PALM BLVD S",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782603",
            "telephone_number": "508-517-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 PALM BLVD S",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782603",
            "telephone_number": "850-517-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JACQULYNE",
        "credential": "ARNP FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11011532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Elizabeth Tallman
• Michael Tallman
• Dominique Tarangelo
• Leslie Tatum
• Grace Taylor
• Mwajuma Denise Teague
• Leah Tedder
• Terence B Mitchell MD Inc
• Therapeutic Connections L.L.C.
• Patricia Thomas, ARNP

• Family Nurse Practitioner in Niceville, FL
• Providers in Niceville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.