Healthcare Provider Details

I. General information

NPI: 1013015973
Provider Name (Legal Business Name): JENNIFER L KOSKINEN A.P.R.N., C.N.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JENNIFER L KNAPP

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 EDGEWATER DR # 3642
ORLANDO FL
32804-6350
US

IV. Provider business mailing address

1317 EDGEWATER DR # 3642
ORLANDO FL
32804-6350
US

V. Phone/Fax

Practice location:
  • Phone: 321-475-4844
  • Fax: 866-504-9297
Mailing address:
  • Phone: 321-475-4844
  • Fax: 866-504-9297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number001104
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number208
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number11029051
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: