EMILY M JAKSICH ARNP NPI 1336510635

NPI Information

NPI: 1336510635
Provider Name: EMILY M JAKSICH, ARNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
3377 RIVERBEND DR
SPRINGFIELD, OR
ZIP 97477
Phone: (541) 222-8400
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Emily M Jaksich, ARNP is an acute care nurse practitioner in Springfield, OR with 9 years of experience. Emily M Jaksich, ARNP NPI is 1336510635. 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:

3377 RIVERBEND DR
SPRINGFIELD, OR
ZIP 97477-803
Phone: (541) 222-8400
Fax: (541) 222-8401

The NPI 1336510635 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 enumeration date for this NPI number is 10/13/2015 and was last updated on 4/28/2023.

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	363L00000X	Nurse Practitioner		202004567NP-PP	OREGON	No
2	363LA2100X	Nurse Practitioner	Acute Care	H124117	IOWA	No
3	363LA2100X	Nurse Practitioner	Acute Care	202004567NP-PP	OREGON	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	R222420	MEDICAID	OREGON

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: 5/5/2024

NPI Synchronization or Removal

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