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General NPI Number Information
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NPI Number | 1184505455
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Entity Type | Individual
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Provider Name | JACLYN GERARDOT FNP
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Gender | Female
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2754 COMPASS DR
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City | GRAND JUNCTION
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State | CO
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Zip | 81506-8714
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Country | US
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Telephone | 970-773-4173
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Fax |
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Provider Business Mailing Address
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Address Line | 3569 E RD
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City | PALISADE
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State | CO
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Zip | 81526-9558
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Country | US
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Telephone | 919-455-7010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1000344
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License Number State | CO
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