Active NPI
Jacqueline Gale Retherford, MS NP
- Women's Health Nurse Practitioner
- Douglas, WY
National Provider Identifier
1467764019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- NP 19602
- Practice address
- 111 S 5TH St
Douglas, WY 82633-2434 - Phone
- (307) 358-7300
- NPI assigned
- Jul 12, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | NP 19602 | CA | Primary |
Addresses
Primary practice location
111 S 5TH St
Douglas, WY 82633-2434
Mailing address
111 S 5TH St
Douglas, WY 82633-2434
Phone (307) 358-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP 19602 | CA | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482192000000",
"number": "1467764019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S 5TH ST",
"city": "DOUGLAS",
"state": "WY",
"postal_code": "826332434",
"telephone_number": "307-358-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S 5TH ST",
"city": "DOUGLAS",
"state": "WY",
"postal_code": "826332434",
"telephone_number": "307-358-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RETHERFORD",
"first_name": "JACQUELINE",
"middle_name": "GALE",
"name_prefix": "Mrs.",
"credential": "MS NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-12",
"last_updated": "2016-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "CA",
"license": "NP 19602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglas, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.