Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP 3063242 | FL |
NPI | 1043203573 |
---|---|
Provider Name | Jennifer Lynn Cline |
First Address | Sarasota, FL 34232-6410 |
Second Address | Sarasota, FL 34232-6410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 03/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
307075100 | (05) | FL |
P00342388 | RAILROAD MEDICARE (01) | FL |
S82022 | (02) | FL |
Y078K | BCBS PROVIDER # (01) | FL |