NPI Code Detail JSON Logo

1558248484 NPI number — CHRISTINA ESTELLE JACOBY AGCNS-BC, DNP, WCC

NPI Number: 1558248484
Health Care Provider/Practitioner: CHRISTINA ESTELLE JACOBY AGCNS-BC, DNP, WCC

Information about “1558248484” NPI (CHRISTINA ESTELLE JACOBY AGCNS-BC, DNP, WCC) exists in 1558248484 in HTML format HTML  |  1558248484 in plain Text format TXT  |  1558248484 in PDF (Portable Document Format) PDF  |  1558248484 in an XML format XML  formats.

NPI Number : 1558248484 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558248484",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JACOBY",
    "FirstName": "CHRISTINA",
    "MiddleName": "ESTELLE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "AGCNS-BC, DNP, WCC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3016 WALSH LOOP SE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RIO RANCHO",
    "MailingAddressStateName": "NM",
    "MailingAddressPostalCode": "87124-2960",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "813-503-6467",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "250 E ALAMEDA ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SANTA FE",
    "PracticeLocationAddressStateName": "NM",
    "PracticeLocationAddressPostalCode": "87501-2186",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "505-995-2128",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/20/2025",
    "LastUpdateDate": "08/20/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163WC0200X",
          "TaxonomyName": "Critical Care Medicine Registered Nurse",
          "LicenseNumber": "RN-87695",
          "LicenseNumberStateCode": "NM",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WE0900X",
          "TaxonomyName": "Enterostomal Therapy Registered Nurse",
          "LicenseNumber": "RN-87695",
          "LicenseNumberStateCode": "NM",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LG0600X",
          "TaxonomyName": "Gerontology Nurse Practitioner",
          "LicenseNumber": "85540",
          "LicenseNumberStateCode": "NM",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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