Healthcare Provider Details

I. General information

NPI: 1679345276
Provider Name (Legal Business Name): JESSICA LINDSEY TAYON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 COMMERCIAL WAY
SPRING HILL FL
34606-3300
US

IV. Provider business mailing address

14347 BARRACUDA RUN
SPRING HILL FL
34609-0527
US

V. Phone/Fax

Practice location:
  • Phone: 135-268-8811
  • Fax: 135-268-6947
Mailing address:
  • Phone: 954-319-0474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11029254
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: