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  7. NPI Record 1528213758

MRS. JACQUELYN ANN SHURDEN
Complete NPI Record 1528213758
Case Manager/Care Coordinator in Nashville, AR

NPI Status: Active since December 02, 2008

Contact Information

508 N 2ND ST
NASHVILLE, AR
ZIP 71852
Phone: (870) 845-3110
Fax: (870) 845-5617

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Other Last Name
  8. Provider Other First Name
  9. Provider Other Middle Name
  10. Provider Other Last Name Type Code
  11. Provider First Line Business Mailing Address
  12. Provider Business Mailing Address City Name
  13. Provider Business Mailing Address State Name
  14. Provider Business Mailing Address Postal Code
  15. Provider Business Mailing Address Country Code If outside U S
  16. Provider Business Mailing Address Telephone Number
  17. Provider Business Mailing Address Fax Number
  18. Provider First Line Business Practice Location Address
  19. Provider Business Practice Location Address City Name
  20. Provider Business Practice Location Address State Name
  21. Provider Business Practice Location Address Postal Code
  22. Provider Business Practice Location Address Country Code If outside U S
  23. Provider Business Practice Location Address Telephone Number
  24. Provider Business Practice Location Address Fax Number
  25. Provider Enumeration Date
  26. Last Update Date
  27. Provider Gender Code
  28. Healthcare Provider Taxonomy Code 1
  29. Healthcare Provider Primary Taxonomy Switch 1
  30. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1528213758. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1528213758
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: JACQUELYN
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Middle Name: ANN
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: MRS.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Other Last Name: MCJUNKINS
Other last name by which the provider being identified is or has been known.
Provider Other First Name: JACQUELYN
Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only.
Provider Other Middle Name: ANN
Other middle name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider middle name’’ if the provider is or has been known by a different last name only.
Provider Other Last Name Type Code: 1
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 2904 ARKANSAS BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: TEXARKANA
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: AR
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 718542536
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 8707734655
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 8707724650
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 508 N 2ND ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: NASHVILLE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: AR
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 718523925
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 8708453110
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8708455617
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 12/2/2008
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 12/2/2008
The date that a record was last updated or changed.
Provider Gender Code: F
The city name in the mailing address of the provider being identified.
Healthcare Provider Taxonomy Code 1: 171M00000X
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Healthcare Provider Primary Taxonomy Switch 1: Y
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Is Sole Proprietor: N
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.