Healthcare Provider Details

I. General information

NPI: 1922886167
Provider Name (Legal Business Name): JESSICA L CHALMERS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38055 ARBOR RIDGE DR
ZEPHYRHILLS FL
33540-1301
US

IV. Provider business mailing address

14311 HILL COUNTRY LN
DADE CITY FL
33525-5112
US

V. Phone/Fax

Practice location:
  • Phone: 813-333-1186
  • Fax:
Mailing address:
  • Phone: 352-263-0295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11028695
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: