Healthcare Provider Details

I. General information

NPI: 1932226305
Provider Name (Legal Business Name): JENNIFER MARIE DELONG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9981 S HEALTHPARK DR # 156
FORT MYERS FL
33908-3618
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-6341
  • Fax: 239-343-6342
Mailing address:
  • Phone: 239-343-6341
  • Fax: 239-343-6342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9326030
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCOA.09303-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: