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General NPI Number Information
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NPI Number | 1790674307
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Entity Type | Individual
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Provider Name | JELESSA CARR
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 359 55TH AVE NE
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City | SAINT PETERSBURG
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State | FL
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Zip | 33703-3015
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Country | US
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Telephone | 727-317-8876
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Fax |
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Provider Business Mailing Address
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Address Line | 359 55TH AVE NE
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City | SAINT PETERSBURG
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State | FL
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Zip | 33703-3015
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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 |
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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 | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 374T00000X
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Taxonomy Name | Religious Nonmedical Nursing Personnel
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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