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General NPI Number Information
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NPI Number | 1083614952
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Entity Type | Individual
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Provider Name | JEANNINE LOUISE EVERETT ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 43 BARKLEY CIR STE. 201
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City | FORT MYERS
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State | FL
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Zip | 33907-4510
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Country | US
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Telephone | 239-936-5250
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Fax | 239-936-9970
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Provider Business Mailing Address
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Address Line | 6 PERROTTI PL
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City | PALM COAST
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State | FL
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Zip | 32164-7452
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Country | US
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Telephone | 239-936-5250
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Fax | 239-936-9970
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 28140609A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 70000188A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | ARNP9428067
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License Number State | FL
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