JACLYN M NIETZER (NPI# 1417290586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417290586 |
| Entity Type | Individual |
| Full Name | JACLYN M NIETZER |
| Credential | PA |
| Practice Address |
5151 N 9th Ave Ste 200 Pensacola FL 32504-8721 |
| Mailing Address |
Po Box 2699 Attn: Shmg/hpe Pensacola FL 32513-2699 |
| Practice Telephone | 8504164970 |
| Practice Fax Number | 8504164969 |
| Mailing Telephone | 8504164970 |
| Mailing Fax Number | 8504164969 |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2015-11-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9107172 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 008573600 | 05 |
| Street Address |
5151 N 9TH AVE STE 200 |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32504-8721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073518882 | Donald W Farmer | Radiology | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2005-06-17 |
| 1417554478 | Natalie Mabire | Registered Nurse | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2020-10-02 |
| 1750993390 | Stewart Jeter | Nurse Anesthetist, Certified Registered | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2020-08-17 |
| 1164030722 | Minh Cai Ryan | Pharmacist | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2020-07-20 |
| 1487270427 | Ashley Gaudet | Nurse Practitioner | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2020-06-24 |
| 1184249880 | Joseph Sasser | Student in an Organized Health Care Education/Training Program | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2020-06-09 |
| 1518581024 | William Lindsay | Student in an Organized Health Care Education/Training Program | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2020-06-01 |
| 1023632668 | Jonathan Rivera Diaz | Student in an Organized Health Care Education/Training Program | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2020-05-29 |
| 1942821392 | Hayley Graham | Pharmacist | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2020-04-27 |
| 1154941292 | Janesha W Thomas | Pharmacist | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2020-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659978393 | Quinyatta Stride | Behavior Technician | 2511 Creighton Rd., Pensacola, FL 32504 | 2020-10-06 |
| 1962017657 | Pt Solutions of Pensacola LLC | Occupational Therapist | 2114 Creighton Rd, Ste C, Pensacola, FL 32504 | 2020-09-10 |
| 1982226742 | Elevate Behavioral Solutions | Behavioral Analyst | 4045 Renoir St, Pensacola, FL 32504 | 2020-05-14 |
| 1760021349 | Veteran Evaluations of Florida | Internal Medicine | 2411 Executive Plaza Drive, Suite A, Pensacola, FL 32504 | 2019-12-31 |
| 1215575527 | First City Health LLC | Pharmacy | 6005 College Parkway, Suite 1, Pensacola, FL 32504 | 2019-12-17 |
| 1184261158 | Claire Ann Letendre | Audiologist | 5153 N 9th Ave Pediatric Off Building, Pensacola, FL 32504 | 2019-12-09 |
| 1083275101 | Benjamin Mcmillon | Chiropractor | 2629 Creighton Road, Suite 1, Pensacola, FL 32504 | 2019-06-28 |
| 1407342595 | Faryal Munir | Student in an Organized Health Care Education/Training Program | Uf Pediatric Residency 5151 North 9th Ave, 6th Floor Nemours, Pensacola, FL 32504 | 2018-07-02 |
| 1497252050 | Sibyl Tenille Page | Nurse Practitioner | 5147 N 9th Ave Ste 322, Pensacola, FL 32504 | 2018-04-10 |
| 1396272589 | Sacred Heart Hospital | General Acute Care Hospital | 2552 Carmel Heights Rd, Pensacola, FL 32504 | 2017-05-18 |
| Find all providers in zip 32504 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891123378 | Donza First Assist | Physician Assistant | 7225 West Fairfield Dr., C-8, Pensacola, FL 32506-3488 | 2013-10-21 |
| 1174505788 | Keith A Berens | Physician Assistant | 1717 North E Street, Suite 422, Pensacola, FL 32501-6339 | 2005-11-18 |
| 1366436362 | Mark William Houston | Physician Assistant | 4012 N 9th Ave, Pensacola, FL 32503-2824 | 2005-09-06 |
| 1558355545 | Anthony A Zembrzuski | Physician Assistant | 1717 N E St Ste 530, Pensacola, FL 32501 | 2005-09-06 |
| 1184171258 | Madeliene Hill | Physician Assistant | 1717 N E St, Pensacola, FL 32501-6339 | 2016-09-07 |
| 1497112270 | Sherri Peete | Physician Assistant | 1717 N E St, Pensacola, FL 32501-6339 | 2016-01-25 |
| 1447615554 | Jessica Sinco | Physician Assistant | 1717 N E St, Suite 208, Pensacola, FL 32501-6339 | 2015-12-17 |
| 1538532692 | Kaley Morris | Physician Assistant | 4724 N Davis Hwy, Pensacola, FL 32503 | 2015-11-10 |
| 1841607678 | Brian Scott Lang | Physician Assistant | 1717 N E St Ste 205, Pensacola, FL 32501-6336 | 2014-07-14 |
| 1013337435 | Kelly Demuynck | Physician Assistant | 4012 N 9th Ave, Pensacola, FL 32503-2824 | 2014-04-24 |
| Find all providers in PENSACOLA | ||||
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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.