Provider Demographics
NPI:1326035999
Name:JAQUITH, BARBARA CLARE (MSN, RN, PNP FNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:CLARE
Last Name:JAQUITH
Suffix:
Gender:F
Credentials:MSN, RN, PNP FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8274 W STUTSMANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-9652
Mailing Address - Country:US
Mailing Address - Phone:231-526-5992
Mailing Address - Fax:231-347-6628
Practice Address - Street 1:345 N DIVISION RD
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-9416
Practice Address - Country:US
Practice Address - Phone:231-347-8382
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704149642363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics