Jean Jacklin, CRNP in Severna Park, MD - Medicare Nurse Practitioner

Jean Jacklin, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Severna Park, Maryland. Her current practice location is 900 Ritchie Hwy, Suite 203, Severna Park, Maryland. You can reach out to her office (for appointments etc.) via phone at (410) 897-2936.

Jean Jacklin is licensed to practice in Maryland (license number R145434) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1043665094.

Contact Information

	Jean Jacklin, CRNP
	900 Ritchie Hwy, Suite 203, Severna Park, MD 21146-4142
	(410) 897-2936
	(410) 793-5240

Map and Direction

Provider's Profile

Full Name	Jean Jacklin
Gender	Female
Speciality	Nurse Practitioner - Family
Location	900 Ritchie Hwy, Severna Park, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043665094
Provider Enumeration Date: 04/27/2016
Last Update Date: 04/27/2016

Medicare PECOS Information:

PECOS PAC ID: 4981993649
Enrollment ID: I20160519000366

Medical Identifiers

Medical identifiers for Jean Jacklin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043665094	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	R145434 (Maryland)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jean Jacklin allows following entities to bill medicare on her behalf.

Entity Name	Personal Physician Care, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326274853 PECOS PAC ID: 3274683289 Enrollment ID: O20090615000031

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jean Jacklin is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jean Jacklin, CRNP 900 Ritchie Hwy, Suite 203, Severna Park, MD 21146-4142 Ph: (410) 897-2936	Jean Jacklin, CRNP 900 Ritchie Hwy, Suite 203, Severna Park, MD 21146-4142 Ph: (410) 897-2936

Reviews and Comments

Nurse Practitioner Nurses in Severna Park, MD

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Danielle Tanner, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 579 Baltimore Annapolis Blvd, Severna Park, MD 21146 Phone: 410-975-5447
Meredith Baker, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 770 Ritchie Hwy Ste W19, Severna Park, MD 21146 Phone: 410-375-0444
Sarah Kuhl, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 692 Ritchie Hwy, Severna Park, MD 21146 Phone: 410-721-2273
Daphne Etienne, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 25 Jones Station Rd W, Severna Park, MD 21146 Phone: 410-647-0451

Jean Jacklin, CRNP - Medicare Nurse Practitioner in Severna Park, MD