Provider Demographics
NPI:1770913055
Name:HALVERSON, JOCELYN (APRN)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:HALVERSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12303 NE 130TH LN
Mailing Address - Street 2:MS 26
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3099
Mailing Address - Country:US
Mailing Address - Phone:425-899-2160
Mailing Address - Fax:425-899-2422
Practice Address - Street 1:12303 NE 130TH LN
Practice Address - Street 2:MS 26
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3099
Practice Address - Country:US
Practice Address - Phone:425-899-2160
Practice Address - Fax:425-899-2422
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60403599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily