Healthcare Provider Details

I. General information

NPI: 1023467362
Provider Name (Legal Business Name): JERRICA SAWYER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3539 LITTLE RD
TRINITY FL
34655-1811
US

IV. Provider business mailing address

2410 NORTHSIDE DR
CLEARWATER FL
33761-2236
US

V. Phone/Fax

Practice location:
  • Phone: 727-846-9419
  • Fax: 727-816-8707
Mailing address:
  • Phone: 727-499-0356
  • Fax: 727-781-3312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9271801
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: