Healthcare Provider Details

I. General information

NPI: 1194757351
Provider Name (Legal Business Name): JENNIFER BARRON MSN, ARNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SE OCEAN BLVD SUITE 200
STUART FL
34996-3332
US

IV. Provider business mailing address

1874 SE PORT ST LUCIE BLVD
PORT SAINT LUCIE FL
34952-5545
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-2115
  • Fax: 772-223-0887
Mailing address:
  • Phone: 772-337-7676
  • Fax: 772-337-9034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9181750
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberARNP9181750
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: