MRS. JACQUELINE LEA AGENBROAD NP - NPI 1447222328 - Nurse Practitioner in Phoenix, AZ

Q: What is Jacqueline Agenbroad's NPI number?

The NPI number for Jacqueline Agenbroad is 1447222328. It was assigned to this individual provider in the NPPES registry on February 3, 2006.

Q: What is Jacqueline Agenbroad's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

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About Mrs. Jacqueline Lea Agenbroad Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JACQUELINE LEA AGENBROAD NP (NPI 1447222328) is an individual nurse practitioner in Phoenix, Arizona, licensed in Arizona (NP290) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1447222328

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMRS. JACQUELINE LEA AGENBROADCredential: NP

Location Address1300 N 12TH ST, SUITE 407Phoenix, AZ 85006-2848

Mailing Address12895 W Pasadena AveLitchfield Park, AZ 85340 · (623) 935-2373 · Fax (623) 932-4558

Phone(602) 239-6762

Fax(602) 239-5112

Sole ProprietorNo

Enumeration DateFebruary 3, 2006

Last NPPES UpdateJune 12, 2008

✔ NPI 1447222328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Licenses✔ Licensed in AZ · NP290✔ Licensed in AZ · RN097748

Definition

(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.

1300 N 12TH ST, Phoenix, AZ 85006

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DIANA LYNELLE DABELL M.D.

Emergency Medicine

1300 N 12TH ST, STE 301
PHOENIX, AZ 85006

Maricopa County (602) 839-6968

PINNACLE COLON AND RECTAL SURGEONS, PLLC

Specialist

1300 N 12TH ST, SUITE 619
PHOENIX, AZ 85006

Maricopa County (602) 714-5482

INTERNISTS, ONCOLOGISTS LTD

Internal Medicine (Hematology & Oncology)

1300 N 12TH ST, SUITE 612
PHOENIX, AZ 85006

Maricopa County (602) 258-4875

PHILIP KACZAR MD PC

Internal Medicine

1300 N 12TH ST, SUITE #516
PHOENIX, AZ 85006

Maricopa County (602) 252-3967

BARBARA J RUNQUIST NP

Nurse Practitioner

1300 N 12TH ST, SUITE 404
PHOENIX, AZ 85006

Maricopa County (602) 839-0265

DR. ROBERT DEAN RIERSON MD

Obstetrics & Gynecology

1300 N 12TH ST, SUITE 501
PHOENIX, AZ 85006

Maricopa County (602) 839-4915

MISS FARRAH L BLACK PA

Physician Assistant (Medical)

1300 N 12TH ST, STE 500
PHOENIX, AZ 85006

Maricopa County (602) 839-2606

VIKTORIA KRAJNC MD

Family Medicine

1300 N 12TH ST, SUITE 605
PHOENIX, AZ 85006

Maricopa County (602) 839-5271

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Agenbroad's NPI number?

The NPI number for Jacqueline Agenbroad is 1447222328. It was assigned to this individual provider in the NPPES registry on February 3, 2006.

Where is Jacqueline Agenbroad located?

Jacqueline Agenbroad practices at 1300 N 12th St Suite 407, Phoenix, AZ 85006. The listed phone number is (602) 239-6762.

What is Jacqueline Agenbroad's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Jacqueline Agenbroad was last updated on June 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.