Healthcare Provider Details

I. General information

NPI: 1275362378
Provider Name (Legal Business Name): JENNIFER ELIZABETH PLAPPERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEALTH PARK BLVD STE 4000
SAINT AUGUSTINE FL
32086-3704
US

IV. Provider business mailing address

300 HEALTH PARK BLVD STE 4000
SAINT AUGUSTINE FL
32086-3704
US

V. Phone/Fax

Practice location:
  • Phone: 904-824-8666
  • Fax:
Mailing address:
  • Phone: 904-824-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9120342
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: