Healthcare Provider Details

I. General information

NPI: 1407707367
Provider Name (Legal Business Name): JENNIFER PIERRE-LOUIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2612 SE CLAYTON ST
STUART FL
34997-5020
US

IV. Provider business mailing address

2612 SE CLAYTON ST
STUART FL
34997-5020
US

V. Phone/Fax

Practice location:
  • Phone: 772-888-5063
  • Fax:
Mailing address:
  • Phone: 772-888-5063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN9424095
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: