JACKI DEGOLYER FNP NPI 1356912497

NPI Information

NPI: 1356912497
Provider Name: JACKI DEGOLYER, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: THE LITTLE CLINIC OF COLORADO LLC

PECOS Registration: Yes

Address:
5544 PROMENADE PKWY
CASTLE ROCK, CO
ZIP 80108
Phone: (303) 562-9157
Get Directions

Jacki Degolyer, FNP is a family nurse practitioner in Castle Rock, CO with 11 years of experience. Jacki Degolyer, FNP NPI is 1356912497. 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:

5544 PROMENADE PKWY
CASTLE ROCK, CO
ZIP 80108-903
Phone: (303) 562-9157

The NPI 1356912497 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 7/9/2021 and was last updated on 2/18/2022.

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	0996679-NP	COLORADO	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	0175594	OTHER	COLORADO	COLORADO REGISTERED NURSE LICENSE
2	227042	OTHER	COLORADO	CDE SPECIAL SERVICE PROVIDER
3	0996679-NP	OTHER	COLORADO	ADVANCED PRACTICE NURSE

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

NPI Synchronization or Removal

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