JACQUELINE DIANE LILLY (NPI# 1114035516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114035516 |
| Entity Type | Individual |
| Full Name | JACQUELINE DIANE LILLY |
| Credential | PHD APRN BC |
| Practice Address |
102 West Utica Street Oswego NY 13126 |
| Practice Telephone | 3153422450 |
| Mailing Telephone | 3153422450 |
| Enumeration Date | 2006-08-26 |
| Last Update Date | 2007-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364S00000X | Clinical Nurse Specialist | RN2539751 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VALUE OPTIONS | 7493000 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205479490 | Jacqueline Alexandra Lilly | Counselor | 700 Churchill Ct Ste 110, Woodstock, GA 30188-6880 | 2019-10-21 |
| Street Address |
102 WEST UTICA STREET |
| City | OSWEGO |
| State | NY |
| Zip Code | 13126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303572 | Elise Fitzsimmons | Specialist/Technologist | 9 Laker Hall, Oswego, NY 13126 | 2020-10-15 |
| 1023651742 | Jessica Lynn Metzger | Physician Assistant | 300 Ny-104 Suite 1, Oswego, NY 13126 | 2019-10-25 |
| 1245887009 | Maureen Adams | Technician | 30 Stone Ridge Drive, Oswego, NY 13126 | 2019-08-26 |
| 1285128314 | Justin Raymond Beebe | Nurse Practitioner | 300 State Route 104 Ste 2, Oswego, NY 13126 | 2018-06-21 |
| 1801311220 | Lynne M Wallace | Registered Nurse | 29 Birch Lane 17b, Oswego, NY 13126 | 2017-08-07 |
| 1497203962 | Lindsay Cheslock | Local Education Agency (LEA) | 529 County Route 25, Oswego, NY 13126 | 2016-09-14 |
| 1942757919 | Aimee Devinny | Registered Nurse | 21 Twin Orchard Drive, Oswego, NY 13126 | 2016-09-07 |
| 1083160295 | Cameron Delmotte | Specialist | 159 West Frist Street, Oswego, NY 13126 | 2016-08-28 |
| 1508319187 | Samantha Thayer | Occupational Therapist | 159 West First Oswego St, Oswego, NY 13126 | 2016-07-29 |
| 1104279595 | Vikram Jala | Internal Medicine | 105 County Route 45a Ste 400, Oswego, NY 13126 | 2016-07-20 |
| Find all providers in zip 13126 | ||||
| Taxonomy Code | 364S00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |
| Notes: Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760022073 | Bohdan Hladun | Clinical Nurse Specialist | 10 Horizon Dr, Huntington, NY 11743-4411 | 2020-01-14 |
| 1801259767 | Ashley Poole | Clinical Nurse Specialist | 262 Kenwood Ave, Rochester, NY 14611-3030 | 2016-03-29 |
| 1760876817 | Kelechi Butler | Clinical Nurse Specialist | 19 Doreen Dr, Staten Island, NY 10303-2136 | 2015-03-26 |
| 1356669998 | Tara Anne Corcoran | Clinical Nurse Specialist | 1040 Main Street, Peekskill, NY 10566-2906 | 2010-05-06 |
| 1124266424 | Elaine Kazakis | Clinical Nurse Specialist | 4208 Medical Center Dr, Fayetteville, NY 13066-6642 | 2009-01-26 |
| 1386845980 | Carol Ann Joyce | Clinical Nurse Specialist | 21 West 86th St, Suite 308, New York, NY 10024 | 2007-05-30 |
| 1841337714 | Susan R. Cohen | Clinical Nurse Specialist | 110 South Franklin Ave, Lynbrook, NY 11563 | 2007-01-31 |
| 1932272309 | Christine Coolidge Rn Cs Phd PC | Clinical Nurse Specialist | 186 W Montauk Hwy D 1, Hampton Bays, NY 11946 | 2006-11-15 |
| 1629156625 | Florence Williams | Clinical Nurse Specialist | 85 Fifth Ave, 938, New York City, NY 10003-3019 | 2006-11-01 |
| 1326132580 | Gail Berkson Malloy | Clinical Nurse Specialist | 110 Jericho Tpk, Suite 102, Floral Park, NY 11001-2019 | 2006-10-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.