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General NPI Number Information
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NPI Number | 1023593647
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Entity Type | Individual
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Provider Name | JESSICA LEVETT FNP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2018
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 65 CHARLTON PL
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City | DEATSVILLE
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State | AL
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Zip | 36022-2697
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Country | US
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Telephone | 334-290-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 1643 NW 136TH AVE STE 100 BLDG H, SUITE 100
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City | SUNRISE
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State | FL
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Zip | 33323-2857
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-130133
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License Number State | AL
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