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Cynthia Ann Jack, NP
Nurse Practitioner in Rockford, Illinois
NPI 1710222807

Cynthia Ann Jack is a Nurse Practitioner based in Rockford, IL. Cynthia Ann Jack practices in Rockford, IL and has the professional credentials of NP. The NPI Number for Cynthia Ann Jack is 1710222807 and holds a License No. 209009900 (Illinois).

The current practice location address for Cynthia Ann Jack is 2300 N Rockton Ave, Rockford, IL and can be reached out via phone at 815-971-2000.

Location: 2300 N Rockton Ave, Rockford, IL, 61103-3619
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710222807
Provider Name
Cynthia Ann Jack
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
2300 N Rockton Ave, Rockford, IL, 61103-3619
Phone Number
815-971-2000
Fax Number
Provider Enumeration Date
11/30/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
209.009900 01 IL STATE OF ILLINOIS LICENSE
1710222807 05 WI
institution
Provider Business Practice Location Address Details
Address
2300 N Rockton Ave
City
Rockford
State
Illinois
Zip
61103-3619
Phone Number
815-971-2000
Fax Number
person
Provider Business Mailing Address Details
Address
2300 N Rockton Ave
City
Rockford
State
Illinois
Zip
61103-3619
Phone Number
815-971-2000
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
209.009900 (Illinois)
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.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Occupational Health
Taxonomy
363LX0106X
License No.
209009900 (Illinois)
Definition
Definition to come...
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