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General NPI Number Information
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NPI Number | 1609673722
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Entity Type | Organization
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Legal Business Name | JS APRN PMH
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 10000 SW INNOVATION WAY
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34987-2111
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Country | US
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Telephone | 954-555-4979
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Fax |
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Provider Business Mailing Address
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Address Line | 12432 SW COASTAL OAK DR
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34987-6927
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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 | NURSE PRACTITIONER
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Name | JANICE SCHIFF
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Credential | PMHNP
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Telephone | 954-555-4979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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