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

Mrs. Jacqulyne S Booker, ANP

Individual provider Nurse Practitioner · NPI 1316991557

Mrs. Jacqulyne S Booker, ANP is a Nurse Practitioner in Bloomington, Indiana. Qualified in 2004, 22 years ago. Practices with Indiana University Health Southern Indiana Physicians LLC, a 484-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
22
Licensed in
IN
In the registry since
2006
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Practice location Address checks out

995 S Clarizz Blvd
Bloomington, IN 47401-5588
Phone: (812) 353-3060
Fax: (812) 353-3070
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71001863 (IN)

Record details

NPI number1316991557
Entity typeIndividual (Type 1)
GenderFemale
Credentials ANP
Sole proprietorNo
NPI enumeratedMay 20, 2006
Last updated in NPPESDecember 2, 2020
Certification dateDecember 2, 2020

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Indiana University Health Southern Indiana Physicians Llc — 484 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Bloomington