Jacqueline F Kennedy, FNP
Individual provider Active NPI Family Nurse Practitioner · Whately, MA
NPI 1609877653 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1609877653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 169562 (MA)
- Practice address
- 181 State Rd
Whately, MA 01093 - Phone
- (413) 665-0176
- Fax
- (413) 665-0176
- NPI assigned
- Aug 2, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whately Health Center | Family | Past | Accepting new patients |
| NP Care of Massachusetts LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 169562 | MA | Yes |
| Primary Care Nurse Practitioner | 363LP2300X | 169562 | MA |
Addresses
Primary practice location
181 State Rd
Whately, MA 01093
Mailing address
P.O. Box 205
Whately, MA 01093
Phone (413) 665-0176
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9709444 | Medicaid | MA | |
| 0380890 | Medicaid | MA |
Other names
- Ms. Jacqueline F Kennedy
Other providers in Whately, MA
All providers in Whately, MA · Family Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.