Doctor Name: | JENNIFER LYNNE ANDERSON |
NPI Number: | 1992041784 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | RN9293651 |
Business Practice Address: | 2987 Blackwater Oaks Dr Mulberry, FL - 338605546 |
Business Phone Number: | 8635216407 |
Business Fax Number: | |
Mailing Address: | 2987 Blackwater Oaks Dr, MULBERRY |
State: | FL |
Postal Code: | 338605546 |
Phone Number: | 8635216407 |
Fax Number: | |
NPI Enumeration Date: | 12/24/2012 |
NPI Last Update Date: | 06/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | RN9293651 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |