Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 9296204 | FL |
N | 111NI0900X | Internist | 9296204 | FL |
N | 363LG0600X | Nurse Practitioner - Gerontology | APRN9296204 | FL |
NPI | 1053899179 |
---|---|
Provider Name | Margarette Jerome |
First Address | West Palm Beach, FL 33412-1944 |
Second Address | West Palm Beach, FL 33412-1944 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2018 |
Last Update Date | 29/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AG07180172 | (05) | FL |
AG07180172 | AGNP (01) | FL |