Jacklyn Jean Miller, BSN, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R32348 Issued in ND

Practice address

E Hwy 18
Pine Ridge Indian Health Services
Pine Ridge, SD 57770

Phone

(605) 867-3010

NPI assigned

Nov 5, 2008

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 5, 2008.

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1386898302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E HWY 18",
            "address_2": "INDIAN HEALTH SERVICE HOSPITAL",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "57770",
            "telephone_number": "605-867-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E HWY 18",
            "address_2": "PINE RIDGE INDIAN HEALTH SERVICES",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "57770",
            "telephone_number": "605-867-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JACKLYN",
        "middle_name": "JEAN",
        "credential": "BSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R32348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Medina
• Barbara Mellor, CNM
• Thomas Edward Menzel, M.D.
• Jessica Mesteth, RN
• Linda L Mesteth, RN
• Mary C Mousseau, RN
• Halona S Murdock Hughes, RN PHN
• Debra Rose Myers, RDH
• Brenda Neiss, NURSING
• Angela Nelson, PHARMD

• All providers in Pine Ridge, SD
• Registered Nurse in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.