Healthcare Provider Details

I. General information

NPI: 1043203573
Provider Name (Legal Business Name): JENNIFER LYNN CLINE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NORTH CATTLEMEN RD SUITE 220
SARASOTA FL
34232-6410
US

IV. Provider business mailing address

600 NORTH CATTLEMAN RD STE 220
SARASOTA FL
34232-6410
US

V. Phone/Fax

Practice location:
  • Phone: 941-371-6565
  • Fax: 941-377-7731
Mailing address:
  • Phone: 941-371-6565
  • Fax: 941-377-7731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP 3063242
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: