Bode, Jacqueline Ann

Bode, Jacqueline Ann is an individual health care provider with primary practice located at 205 W Park Ave Ste 103 , Champaign IL 61820-7888. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Bode, Jacqueline Ann can be contacted via phone (217) 284-6236.

Contact Information

Primary practice address
205 W Park Ave Ste 103 Champaign IL 61820-7888
Phone: (217) 284-6236
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 277.002017 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 277.002017 Illinois

Profile Details

NPI number 1245572213
LBN Legal business name Bode, Jacqueline Ann
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 18th, 2013
Last updated May 1st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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