Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacqueline Lee Henry, APRN-NP

Individual provider Family Nurse Practitioner · NPI 1063239846

Jacqueline Lee Henry, APRN-NP is a Nurse Practitioner in South Bend, Indiana. Qualified in 2024, 2 years ago. Practices with Mosaic Community Health, a 79-clinician group and accepts Medicare assignment. Licensed in Indiana and Oregon.

Years since qualifying
2
Licensed in
IN, OR
In the registry since
2024
Specialties on file
3
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

6301 University Commons
South Bend, IN 46635-1571
Phone: (574) 251-1210
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10033768 (OR)
Nurse Practitioner Taxonomy 363L00000X · Licence 10033768 (OR)
Registered Nurse Taxonomy 163W00000X · Licence 28301774A (IN)

Record details

NPI number1063239846
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-NP
Sole proprietorNo
NPI enumeratedSeptember 24, 2024
Last updated in NPPESMay 26, 2026
Certification dateMay 26, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Mosaic Community Health — 79 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in South Bend