Jacquelynn Ann Rubsam, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11015528 Issued in FL

Practice address

638 Bird Bay Dr E Apt 203
Venice, FL 34285-6262

Phone

(216) 513-0824

NPI assigned

Apr 19, 2018

Last updated

Sep 9, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Certified Nurse Practitioner, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1790272235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 BIRD BAY DR E APT 203",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342856262",
            "telephone_number": "216-513-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 BIRD BAY DR E APT 203",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342856262",
            "telephone_number": "216-513-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBSAM",
        "first_name": "JACQUELYNN",
        "middle_name": "ANN",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11015528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas J Ruane, M.D.
• David M Rubin, OD
• Jillian Rubin
• Shellie G Rubin
• James R. Rubinsak, M.D.
• Wendy Russell
• Francis Alberto Russo
• Oliva Russo, APRN
• Shelly Russo, APRN
• Kimberly Ann Ruzek, MD

• Family Nurse Practitioner in Venice, FL
• Providers in Venice, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.