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General NPI Number Information
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NPI Number | 1760262000
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Entity Type | Individual
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Provider Name | JENELLE MARIE SULEYMAN APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 717 NE 5TH ST
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429
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Country | US
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Telephone | 352-212-7910
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Fax | 352-204-1449
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Provider Business Mailing Address
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Address Line | 717 NE 5TH ST
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-4325
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Country | US
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Telephone | 352-212-7910
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Fax | 352-204-1449
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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 | APRN11029748
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN9435912
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License Number State | FL
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