Jennifer Ann Kern, FNP

Primary specialty

Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X

License

RN169351 Issued in AZ

Practice address

1858 Golden Gate Ave
Kingman, AZ 86401-4055

Phone

(928) 529-5349

Fax

(928) 529-5352

NPI assigned

Jul 23, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: jennifer.kern@dh-az.direct.office.nextgen.com

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1992113906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1858 GOLDEN GATE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014055",
            "telephone_number": "928-529-5349",
            "fax_number": "928-529-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1858 GOLDEN GATE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014055",
            "telephone_number": "928-529-5349",
            "fax_number": "928-529-5352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2082 Mesquite Ave",
            "address_2": "SUITE A100",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864036710",
            "country_code": "US",
            "telephone_number": "928-453-2727",
            "fax_number": "928-453-2828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1510 N Stockton Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Kingman",
            "state": "AZ",
            "postal_code": "86401",
            "country_code": "US",
            "telephone_number": "928-753-1177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1510 N Stockton Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Kingman",
            "state": "AZ",
            "postal_code": "86401",
            "country_code": "US",
            "telephone_number": "928-753-1177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERN",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-23",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "AZ",
            "license": "RN169351",
            "primary": true
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "AZ",
            "license": "AP7314",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "RN169351",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADV NURSE PRACTITIONER",
            "identifier": "AP7314",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Kash, M.S.
• Reza Kazemi, M.D.
• Maryann Keese
• Michael Kellam
• Steven Kemp, FNP APPLICANT
• Ahmad Saeed Khan, M.D.
• Mahmood Khan, M.D.
• Muhammad Azam Khan, MD
• Kids Little Smiles Dentistry
• Yong Chan Kim, M.D.

• Family Health Clinical Nurse Specialist in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Family Health Clinical Nurse Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.