JACQUELYN E BACCHUS FNP NPI 1831380773

NPI Information

NPI: 1831380773
Provider Name: JACQUELYN E BACCHUS, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
855 MONTGOMERY
FORT WORTH, TX
ZIP 76107
Phone: (817) 735-2440
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Jacquelyn E Bacchus, FNP is a family nurse practitioner in Fort Worth, TX. Jacquelyn E Bacchus, FNP NPI is 1831380773. 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:

855 MONTGOMERY
FORT WORTH, TX
ZIP 76107-553
Phone: (817) 735-2440

The enumeration date for this NPI number is 8/6/2007 and was last updated on 3/2/2015.

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	363LF0000X	Nurse Practitioner	Family	03590	LOUISIANA	No
2	363LF0000X	Nurse Practitioner	Family	599838	TEXAS	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	Other Provider Identifier Issuer
1	340638101	MEDICAID	TEXAS
2	8962NL	OTHER	TEXAS	BCBS
3	375857YPF6	MEDICARE PIN	TEXAS

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

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