MEDICARE: MRS. PAULETTE Y. JARRETT-RODNEY FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209.010525	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861826604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULETTE Y. JARRETT-RODNEY FNP

Provider Business Mailing Address
First Line	:	271 SILVER LN
Second Line	:
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-2536
Country	:	US
Telephone Number	:	708-345-2505
Fax Number	:

Provider Business Practice Location Address
First Line	:	1649 N PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-5207
Country	:	US
Telephone Number	:	773-278-6868
Fax Number	:	773-278-6922

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2013
Last Update Date	:	05/15/2014

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