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General NPI Number Information
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NPI Number | 1588974869
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Entity Type | Individual
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Provider Name | JESICA CLEVELAND ARCHIE MSN
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Gender | Female
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 04/30/2020
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Provider Practice Location Address
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Address Line | 1720 S ORANGE AVE
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City | ORLANDO
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State | FL
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Zip | 32806-2945
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Country | US
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Telephone | 407-540-1000
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Fax | 407-540-1011
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Provider Business Mailing Address
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Address Line | 1720 S ORANGE AVE
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City | ORLANDO
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State | FL
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Zip | 32806-2945
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Country | US
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Telephone | 407-540-1000
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Fax | 407-540-1011
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 4317
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License Number State | SC
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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 | APRN9497670
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License Number State | FL
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