JACEY L DYKSTRA (NPI# 1568880151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568880151 |
| Entity Type | Individual |
| Full Name | JACEY L DYKSTRA |
| Credential | APRN |
| Practice Address |
615 E Princeton St Ste 416 Orlando FL 32803-1469 |
| Practice Telephone | 4073031687 |
| Practice Fax Number | 4073031729 |
| Mailing Telephone | 4073031687 |
| Mailing Fax Number | 4073031729 |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2019-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | ARNP9308605 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
615 E PRINCETON ST STE 416 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32803-1469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821227133 | Monique Gupta Kumar | Dermatology | 615 E Princeton St Ste 416, Orlando, FL 32803-1469 | 2009-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255952636 | Laiza Souza Tanner | Technician | 500 E Rollins St, Orlando, FL 32803 | 2020-04-27 |
| 1407415342 | Betty Carrol | Marriage & Family Therapist | 1516 E Colonial Dr Ste 100, Orlando, FL 32803 | 2019-06-12 |
| 1326606047 | Anthony Balingit | Physical Therapy Assistant | 1870 Aloma Avenue, Orlando, FL 32803 | 2019-05-29 |
| 1396234795 | Natasha Le Morvan | Technician/Technologist | 1364 Ferris Ave, Orlando, FL 32803 | 2018-05-02 |
| 1306365796 | Sarah E Fischer | Nurse Practitioner | Adventhealth Orlando, 601 E Rollins St, Orlando, FL 32803 | 2017-09-17 |
| 1710404249 | Emilia's Direct Care Agency | Community/Behavioral Health | 3218 E Colonial Dr Rm 118, Orlando, FL 32803 | 2017-08-25 |
| 1760907620 | Kalie Brianne Morris | Speech-Language Pathologist | 1120 Portland Ave Unit 7, Orlando, FL 32803 | 2017-08-11 |
| 1972024271 | Tatiana Ungredda | Psychologist | 5201 Raymond St Ste 424, Orlando, FL 32803 | 2017-06-28 |
| 1063942662 | Michael Thomas | Licensed Practical Nurse | 101 South Bumby Ave, E11, Orlando, FL 32803 | 2017-06-15 |
| 1598209249 | Danielle Marin | Behavioral Analyst | 2807 Edgewater Dr, Orlando, FL 32803 | 2016-12-15 |
| Find all providers in zip 32803 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395125 | Olayemi Olusola Agbaje | Nurse Practitioner | 5900 Lake Ellenor Dr Ste 150, Orlando, FL 32809-4663 | 2020-10-27 |
| 1871192054 | Maria Lena Afxendiou | Nurse Practitioner | 11058 Grande Pines Cir Apt 821, Orlando, FL 32821-9333 | 2020-10-20 |
| 1396352316 | Erin Fahy | Nurse Practitioner | 2737 Rainbow Springs Ln, Orlando, FL 32828-7783 | 2020-09-24 |
| 1093321457 | Sherry Benson Loiselle | Nurse Practitioner | 19407 Charrice Ct, Orlando, FL 32833-5528 | 2020-09-21 |
| 1861003949 | Raul Junior Beltran | Nurse Practitioner | 1612 E Central Blvd, Orlando, FL 32803-5902 | 2020-08-12 |
| 1780202945 | Vivi Nguyen | Nurse Practitioner | 1700 Sand Lake Rd Ste D112, Orlando, FL 32809-9149 | 2020-07-13 |
| 1902424385 | Estel Angelika Hernandez | Nurse Practitioner | 16039 Old Cheney Hwy, Orlando, FL 32833-2716 | 2020-07-11 |
| 1801414727 | Teresa A Kamps | Nurse Practitioner | 1850 Oak Grove Chase Dr, Orlando, FL 32820-2265 | 2020-07-07 |
| 1073130688 | Iris N Bosse | Nurse Practitioner | 10401 Post Office Blvd W Unit 621212, Orlando, FL 32862-8485 | 2020-06-30 |
| 1902430473 | Faith Daza | Nurse Practitioner | 14315 Golden Rain Tree Blvd, Orlando, FL 32828-4843 | 2020-02-24 |
| Find all providers in ORLANDO | ||||
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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.