Jacquelynn Marie Kubay, ARNP,NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

714372 Issued in FL

Practice address

12700 Creekside LN
Suite 101
Fort Myers, FL 33919-3356

Phone

(407) 797-8208

NPI assigned

Nov 27, 2012

Last updated

Mar 4, 2013By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

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  NPD (past)

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1760726061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19149 MEADOWBROOK CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339036640",
            "telephone_number": "407-469-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 CREEKSIDE LN",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193356",
            "telephone_number": "407-797-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBAY",
        "first_name": "JACQUELYNN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "ARNP,NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "714372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antoinette Kruse, MSW
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• Subhash Kshetrapal, M.D.
• Kuhn Family Chiropractic LLC
• Alexander Kuhn, D.C.
• Michael William Kuhn, D.O.
• Paul Kuhn
• Andrea R Kuiper, P.A.

• Adult Health Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.