Healthcare Provider Details

I. General information

NPI: 1811563968
Provider Name (Legal Business Name): JENNIFER LYNN PARKER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2021
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5350 SPRING HILL DR
SPRING HILL FL
34606-4562
US

IV. Provider business mailing address

11904 PALM BAY CT
NEW PORT RICHEY FL
34654-2052
US

V. Phone/Fax

Practice location:
  • Phone: 352-688-8116
  • Fax: 352-686-9477
Mailing address:
  • Phone: 727-534-0667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9380374
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11013126
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: