Individual provider Active NPI

Jacqueline Giudice, APRN-CNP

  • Family Nurse Practitioner
  • Bristow, OK
National Provider Identifier
1780057646
Registry record updated Nov 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
82054 Issued in OK
Practice address
700 W 7TH Ave
Bristow, OK 74010-2302
Phone
(918) 367-2215
NPI assigned
Nov 1, 2015
Last updated
Nov 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2015

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 82054 OK Primary

Addresses

Primary practice location

700 W 7TH Ave
Bristow, OK 74010-2302

Mailing address

700 W 7TH Ave
Bristow, OK 74010-2302
Phone (918) 367-2215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160212001442 OK Practitioner - Nurse Practitioner 0345544292 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
82054OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Tulsa County, LLC CurrentSince Dec 18, 2023 Accepting new patients
Usacs Observation Medicine Services of Oklahoma, LLC CurrentSince Oct 10, 2023 Accepting new patients
Advanced Wound Therapy CurrentSince Mar 5, 2024 Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

2488 E 81st St
Ste 2000
Tulsa, OK 74137
Phone (918) 803-1190

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1446336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446336000000",
    "number": "1780057646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W 7TH AVE",
            "city": "BRISTOW",
            "state": "OK",
            "postal_code": "740102302",
            "telephone_number": "918-367-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W 7TH AVE",
            "city": "BRISTOW",
            "state": "OK",
            "postal_code": "740102302",
            "telephone_number": "918-367-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIUDICE",
        "first_name": "JACQUELINE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-01",
        "last_updated": "2015-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "82054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristow, OK

Sources for this page

Verify at the official NPI Registry.