Healthcare Provider Details

I. General information

NPI: 1902449663
Provider Name (Legal Business Name): JENNIFER F HARBOUR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1563 LAND O LAKES BLVD
LUTZ FL
33549-2930
US

IV. Provider business mailing address

1563 LAND O LAKES BLVD
LUTZ FL
33549-2930
US

V. Phone/Fax

Practice location:
  • Phone: 813-856-2946
  • Fax:
Mailing address:
  • Phone: 813-856-2946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11004551
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: