Healthcare Provider Details

I. General information

NPI: 1558274027
Provider Name (Legal Business Name): JODIANN VANESSA FRANCIS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 BOYETTE RD # 807
RIVERVIEW FL
33569-8000
US

IV. Provider business mailing address

10810 BOYETTE RD # 807
RIVERVIEW FL
33569-8000
US

V. Phone/Fax

Practice location:
  • Phone: 334-221-9657
  • Fax:
Mailing address:
  • Phone: 334-221-9657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11050533
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: