Individual provider Active NPI

Stephana Jean Jacques

  • Registered Nurse
  • Coconut Creek, FL
National Provider Identifier
1639016769
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
9707435 Issued in FL
Practice address
1941 NW 38TH Ter
Coconut Creek, FL 33066-3006
Phone
(786) 614-2823
NPI assigned
Apr 29, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9707435 FL Primary

Addresses

Primary practice location

1941 NW 38TH Ter
Coconut Creek, FL 33066-3006

Mailing address

1941 NW 38TH Ter
Coconut Creek, FL 33066-3006

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
9707435FLMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1777420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1639016769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 NW 38TH TER",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330663006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 NW 38TH TER",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330663006",
            "telephone_number": "786-614-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN JACQUES",
        "first_name": "STEPHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9707435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.