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General NPI Number Information
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NPI Number | 1689989683
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Entity Type | Individual
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Provider Name | JESSICA L CO MSN, APRN, RN
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Gender | Female
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 5647 HOLLYWOOD BLVD STE 390
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6325
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Country | US
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Telephone | 954-265-7450
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Fax | 954-265-7469
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Provider Business Mailing Address
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Address Line | 2900 CORPORATE WAY # WAYD
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City | MIRAMAR
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State | FL
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Zip | 33025-3925
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Country | US
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Telephone | 954-276-5603
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3009141
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11738
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License Number State | OH
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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 | COA.11738-NP
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | 11009975
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License Number State | FL
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