Jacqleen Jaana Stetson, AGPCNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP11203 Issued in AZ

Practice address

15333 N Pima Rd Ste 305
Scottsdale, AZ 85260-2717

Phone

(669) 490-1088

NPI assigned

Apr 20, 2018

Last updated

Oct 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: jacqleen.stetson@71082555932676.direct.elationemr.com

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1700373107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 E TYSON ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852255498",
            "telephone_number": "928-595-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15333 N PIMA RD STE 305",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602717",
            "telephone_number": "669-490-1088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1170 E Tyson St",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852255498",
            "country_code": "US",
            "telephone_number": "928-595-1568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STETSON",
        "first_name": "JACQLEEN",
        "middle_name": "JAANA",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "AZ",
            "license": "AP11203",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP11203",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP11203",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "AP11203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Gerontology Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.