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General NPI Number Information
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NPI Number | 1063309144
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Entity Type | Individual
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Provider Name | JENNY LEE PALENCIA LLAVE MSN, RN
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Gender | Female
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 3250 ZEMKE AVE
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City | TAMPA
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State | FL
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Zip | 33621-5023
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Country | US
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Telephone | 520-429-0044
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Fax |
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Provider Business Mailing Address
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Address Line | MACDILL AFB 6TH MEDICAL GROUP 3250 ZEMKE AVENUE
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City | TAMPA
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State | FL
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Zip | 33608
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Country | US
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Telephone | 520-429-0044
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 26NR18810100
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License Number State | NJ
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