Individual provider Active NPI

Jacqueline Regina Love-Ryan

  • Psychiatric/Mental Health Registered Nurse
  • Pine Bluff, AR
National Provider Identifier
1497922868
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
R21955 Issued in AR
Practice address
620 S Laurel
Pine Bluff, AR 71601-4859
Phone
(870) 534-4900
Fax
(870) 534-4900
NPI assigned
May 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X R21955 AR Primary

Addresses

Primary practice location

620 S Laurel
Pine Bluff, AR 71601-4859

Mailing address

620 S Laurel St
Pine Bluff, AR 71601-4859
Phone (870) 534-4900

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R21955ARMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1497922868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 S LAUREL ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716014859",
            "telephone_number": "870-534-4900",
            "fax_number": "870-534-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S LAUREL",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716014859",
            "telephone_number": "870-534-4900",
            "fax_number": "870-534-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE-RYAN",
        "first_name": "JACQUELINE",
        "middle_name": "REGINA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AR",
            "license": "R21955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.