Healthcare Provider Details

I. General information

NPI: 1699630780
Provider Name (Legal Business Name): JAY KEVIN PATTERSON APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 7TH ST N
NAPLES FL
34102-5754
US

IV. Provider business mailing address

20336 ESTERO CROSSING BLVD
ESTERO FL
33928-4064
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-5000
  • Fax:
Mailing address:
  • Phone: 239-777-8118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN9375111
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: