Jaclyn Kay Engdahl, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

R43170 Issued in ND

Practice address

520 3Rd St NW
Jamestown, ND 58401-2968

Phone

(701) 253-6308

NPI assigned

Jan 12, 2023

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1447964580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 3RD ST NW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584012968",
            "telephone_number": "701-253-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 3RD ST NW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584012968",
            "telephone_number": "701-253-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGDAHL",
        "first_name": "JACLYN",
        "middle_name": "KAY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "ND",
            "license": "R43170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Elizabeth Eckstein
• Edward a Anderson DDS PC
• Jennifer Marie Ekern, PMHNP
• Sydney Dianne Ellingson, CEP
• Heather Lynn Elliott, PMHNP
• Ann E Engel, PSYD
• Lacey Marie Enger, BMS
• Steven R Ennis, BA
• Alyssa Eppen-Tanem
• Beth Erbele, RN

• All providers in Jamestown, ND
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.