JACQLEEN JAANA STETSON AGPCNP NPI 1700373107

NPI Information

NPI: 1700373107
Provider Name: JACQLEEN JAANA STETSON, AGPCNP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Organization: KMTRASK PLLC

PECOS Registration: Yes

Address:
15333 N PIMA RD STE 305
SCOTTSDALE, AZ
ZIP 85260
Phone: (669) 490-1088
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Jacqleen Jaana Stetson, AGPCNP is a gerontology nurse practitioner in Scottsdale, AZ with 6 years of experience. Jacqleen Jaana Stetson, AGPCNP NPI is 1700373107. 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:

15333 N PIMA RD STE 305
SCOTTSDALE, AZ
ZIP 85260-717
Phone: (669) 490-1088

The NPI 1700373107 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 4/20/2018 and was last updated on 10/6/2021.

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	363LC1500X	Nurse Practitioner	Community Health	AP11203	ARIZONA	No
2	363LA2200X	Nurse Practitioner	Adult Health	AP11203	ARIZONA	No
3	363LP2300X	Nurse Practitioner	Primary Care	AP11203	ARIZONA	No
4	363LG0600X	Nurse Practitioner	Gerontology	AP11203	ARIZONA	Yes

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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