Healthcare Provider Details

I. General information

NPI: 1215633870
Provider Name (Legal Business Name): JENNIFER ANN RAPP ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 MAITLAND AVE STE 1000
ALTAMONTE SPRINGS FL
32701-4908
US

IV. Provider business mailing address

1821 SWEETWATER WEST CIR
APOPKA FL
32712-2483
US

V. Phone/Fax

Practice location:
  • Phone: 407-332-6366
  • Fax:
Mailing address:
  • Phone: 407-209-7968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11024087
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: