KIM JAQUISH RNP NPI 1245228485

NPI Information

NPI: 1245228485
Provider Name: KIM JAQUISH, RNP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
1500 DODSON AVE
STE 125
FORT SMITH, AR
ZIP 72901
Phone: (479) 573-7960
Get Directions

Kim Jaquish, RNP is a gerontology nurse practitioner in Fort Smith, AR. Kim Jaquish, RNP NPI is 1245228485. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1500 DODSON AVE
STE 125
FORT SMITH, AR
ZIP 72901-182
Phone: (479) 573-7960
Fax: (479) 573-7961

The NPI 1245228485 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 10/12/2005 and was last updated on 8/27/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	P01373	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	5V417	MEDICARE PIN	ARKANSAS
2	S98792	MEDICARE UPIN	ARKANSAS
3	100013980A	MEDICAID	OKLAHOMA
4	155652741	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »