Healthcare Provider Details

I. General information

NPI: 1134582711
Provider Name (Legal Business Name): JENNA MINNI ARNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 MILITARY TRL STE 200
JUPITER FL
33458
US

IV. Provider business mailing address

3384 W COMMUNITY DR
JUPITER FL
33458-8239
US

V. Phone/Fax

Practice location:
  • Phone: 561-746-2110
  • Fax:
Mailing address:
  • Phone: 772-380-3297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9407892
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP9407892
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: