Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | ARNP9334939 | FL |
N | 363LG0600X | Nurse Practitioner - Gerontology | ARNP9334939 | FL |
N | 363LP2300X | Nurse Practitioner - Primary Care | ARNP9334939 | FL |
NPI | 1083096853 |
---|---|
Provider Name | Jayna Patel |
First Address | Port St Lucie, FL 34986-2019 |
Second Address | Port St Lucie, FL 34986-2019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2015 |
Last Update Date | 30/07/2015 |