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JACQUELINE DEFFENBAUGH APN WHNP NPI 1174535306


NPI Information

NPI: 1174535306
Provider Name: JACQUELINE DEFFENBAUGH, APN, WHNP
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Individual

Specialization: Women's Health

Organization: ADVANCED WOMENS HEALTHCARE SC

PECOS Registration: Yes

Address:
2304 STERN DR
BLOOMINGTON, IL
ZIP 61704
Phone: (309) 663-0411
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Jacqueline Deffenbaugh, APN, WHNP is a women's health nurse practitioner in Bloomington, IL with 29 years of experience. Jacqueline Deffenbaugh, APN, WHNP NPI is 1174535306. 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:

2304 STERN DR
BLOOMINGTON, IL
ZIP 61704-487
Phone: (309) 663-0411
Fax: (309) 662-2018

The NPI 1174535306 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)
  • Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory (HCPCS:Q0091)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)

The enumeration date for this NPI number is 8/13/2006 and was last updated on 3/31/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LW0102XNurse PractitionerWomen's Health209002146ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1216064OTHERMEDICARE GROUP PTAN
2216064001MEDICARE PIN

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: 11/14/2023

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.