Jackie Marie Robinson, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

N36113542 Issued in WA

Practice address

615 E Main St
Craigmont, ID 83523-5099

Phone

(208) 717-7275

NPI assigned

Jan 13, 2021

Last updated

Jan 13, 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 1

Addresses

Other names 1

• Jackie Marie Dupuis Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1811586001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E MAIN ST",
            "city": "CRAIGMONT",
            "state": "ID",
            "postal_code": "835235099",
            "telephone_number": "208-717-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E MAIN ST",
            "city": "CRAIGMONT",
            "state": "ID",
            "postal_code": "835235099",
            "telephone_number": "208-717-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JACKIE",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "N36113542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "DUPUIS",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Nurse Practitioner in Craigmont, ID
• Providers in Craigmont, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.