NPIMap

Individual provider Active NPI

Erica Lynne Jantzen, CRNP

  • Family Nurse Practitioner
  • Tuscumbia, AL
National Provider Identifier
1588894083
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-103741 Issued in AL
Practice address
234 Keller Park Blvd
Tuscumbia, AL 35674-1417
Phone
(256) 381-6963
Fax
(256) 381-6018
NPI assigned
Jul 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-103741 AL Primary

Addresses

Primary practice location

234 Keller Park Blvd
Tuscumbia, AL 35674-1417

Mailing address

234 Keller Park Blvd
Tuscumbia, AL 35674-1417
Phone (256) 381-6963

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
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Valley Pediatric Associatesinc. Past Accepting new patients
North Alabama Emergency Physicians LLC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1588894083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 KELLER PARK BLVD",
            "city": "TUSCUMBIA",
            "state": "AL",
            "postal_code": "356741417",
            "telephone_number": "256-381-6963",
            "fax_number": "256-381-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 KELLER PARK BLVD",
            "city": "TUSCUMBIA",
            "state": "AL",
            "postal_code": "356741417",
            "telephone_number": "256-381-6963",
            "fax_number": "256-381-6018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANTZEN",
        "first_name": "ERICA",
        "middle_name": "LYNNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-103741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscumbia, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.