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General NPI Number Information
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NPI Number | 1265843692
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Entity Type | Individual
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Provider Name | JESSICA MARIE D'ANGELO MS, NP
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Gender | Female
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 9611 W BROWARD BLVD
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City | PLANTATION
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State | FL
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Zip | 33324-2334
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Country | US
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Telephone | 954-924-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 417
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City | STUART
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State | FL
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Zip | 34995-0417
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Country | US
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Telephone | 772-223-2832
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP95010855
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 209010986
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APRN11004097
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11004097
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License Number State | FL
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