JACQUELYN ANN HEDSTROM (NPI# 1891206215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891206215 |
| Entity Type | Individual |
| Full Name | JACQUELYN ANN HEDSTROM |
| Credential | DNP APRN PMHNP-BC |
| Practice Address |
1000 Highway 12 Hettinger ND 58639-7530 |
| Mailing Address |
11506 Fredlund Rd Hettinger ND 58639-9271 |
| Practice Telephone | 7015674561 |
| Mailing Telephone | 7019280305 |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2017-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R20596 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1000 HIGHWAY 12 |
| City | HETTINGER |
| State | ND |
| Zip Code | 58639-7530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194766485 | Joan Lea Upton | Physical Therapist | 1000 Highway 12, Hettinger, ND 58639-7530 | 2006-06-09 |
| 1225647860 | Rebecca Howe | Nurse Practitioner | 1000 Highway 12, Hettinger, ND 58639-7530 | 2020-07-29 |
| 1639724099 | Ashley Lynn Bostyan | Nurse Practitioner | 1000 Highway 12, Hettinger, ND 58639-7530 | 2019-08-02 |
| 1871017616 | Lesley D Kling | Nurse Practitioner | 1000 Highway 12, Hettinger, ND 58639 | 2017-08-02 |
| 1083049431 | Jodi Lynn Wilson | Nurse Practitioner | 1000 Highway 12, Hettinger, ND 58639-7530 | 2013-09-04 |
| 1669793410 | Stacie Marie Wellman | Family Medicine | 1000 Highway 12, Hettinger, ND 58639-7530 | 2010-06-16 |
| 1861623456 | Carrie Ann Kathleen Ranum | Pediatrics | 1000 Highway 12, Hettinger, ND 58639-7530 | 2009-07-31 |
| 1609035120 | Joshua Ranum | Family Medicine | 1000 Highway 12, Hettinger, ND 58639-7530 | 2008-06-09 |
| 1528240694 | West River Health Services | Durable Medical Equipment & Medical Supplies | 1000 Highway 12, Hettinger, ND 58639-7530 | 2007-11-30 |
| 1518089499 | West River Health Services | Ambulance | 1000 Highway 12, Hettinger, ND 58639-7530 | 2007-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215149984 | Mitchell C. Schultz | Pharmacist | 105 6th St Se, Hettinger, ND 58639 | 2007-05-04 |
| 1861612111 | Gary William Dewhirst | Pharmacist | 305 13th St S, Hettinger, ND 58639 | 2007-04-27 |
| 1649677220 | Liane Ruhland | Social Worker | 609 2nd Ave N, Hettinger, ND 58639-0550 | 2014-11-26 |
| 1154535151 | Susan K Hallen | Pharmacist | 603 N 4th St, Hettinger, ND 58639-0808 | 2007-05-09 |
| 1225145345 | Suzan Jean Hanson | Chiropractor | 117 S. Main, Hettinger, ND 58639-1347 | 2006-08-24 |
| 1174873939 | Kimberly Anne Radig | Pharmacist | 112 S Main St, Hettinger, ND 58639-7031 | 2012-09-19 |
| 1396835237 | White Drug Co of Jamestown Inc | Durable Medical Equipment & Medical Supplies | 112 S Main St, Hettinger, ND 58639-7031 | 2006-10-13 |
| 1902992704 | West River Health Services | Home Health | 700 4th St N, Hettinger, ND 58639-7221 | 2006-10-05 |
| 1043819709 | Laura Lea Lurz Cordes | Technician | 300 11th Ave N, Hettinger, ND 58639-7306 | 2020-10-22 |
| 1659996924 | Encompass Therapy LLC | Clinic/Center | 600 2nd Ave N, Hettinger, ND 58639-7448 | 2020-06-12 |
| Find all providers in zip 58639 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346860541 | Inspired Healthcare, Pllc | Nurse Practitioner | 1301 6th Ave Sw, Jamestown, ND 58401-5220 | 2020-04-17 |
| 1447735030 | Lisa Marie Clinkscales | Nurse Practitioner | 521 S 6th St, Grand Forks, ND 58201-4617 | 2018-09-28 |
| 1881138238 | Ashley A Beeter, Pmh-dnp | Nurse Practitioner | 24 North Main Street, Suite K, Minot, ND 58703 | 2016-12-05 |
| 1346792561 | Heather Counts | Nurse Practitioner | 11 Main Street East, Dunseith, ND 58329 | 2016-11-04 |
| 1831431949 | Ashley Ann Thiel | Nurse Practitioner | 24 Main St N, Suite K, Minot, ND 58703-3104 | 2013-03-27 |
| 1336481803 | Jacqualine Kay Gervais | Nurse Practitioner | 510. 4th St S, Prairie St. John's, Fargo, ND 58103 | 2013-03-22 |
| 1366782609 | Wanda Ann Sprenger | Nurse Practitioner | 407 3rd St. S.e., Minot, ND 58701-4470 | 2013-02-24 |
| 1275845547 | Nicole Olivia Wilson | Nurse Practitioner | 914 1st Ave Se, Minot, ND 58701-4008 | 2010-07-02 |
| 1841443025 | Lisa Karen Watkins | Nurse Practitioner | 1850 Billings Dr, Bismarck, ND 58504-7251 | 2008-10-31 |
| 1275715682 | Jennifer L Keplin | Nurse Practitioner | 1015 Hospital Rd. Suite A, Belcourt, ND 58316 | 2007-11-28 |
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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.