Active NPI
Jacqueline Ann Parker, ACNP
- Acute Care Nurse Practitioner
- Dearborn, MI
National Provider Identifier
1821311481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 4704169276
- Practice address
- 4538 Rosalie St
Dearborn, MI 48126-2827 - Phone
- (313) 802-9399
- NPI assigned
- Mar 10, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 4704169276 | MI | Primary |
Addresses
Primary practice location
4538 Rosalie St
Dearborn, MI 48126-2827
Mailing address
4538 Rosalie St
Dearborn, MI 48126-2827
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704169276 | MI | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268179200000",
"number": "1821311481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4538 ROSALIE ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4538 ROSALIE ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262827",
"telephone_number": "313-802-9399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "JACQUELINE",
"middle_name": "ANN",
"credential": "ACNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-10",
"last_updated": "2010-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MI",
"license": "4704169276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.