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General NPI Number Information
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NPI Number | 1891019063
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Entity Type | Individual
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Provider Name | JENNIFER ELLEN FACCIOLI ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 03/17/2010
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Provider Practice Location Address
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Address Line | 1425 CREECH RD
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City | NAPLES
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State | FL
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Zip | 34103-4207
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Country | US
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Telephone | 239-262-8923
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Fax |
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Provider Business Mailing Address
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Address Line | 725 107TH AVE N
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City | NAPLES
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State | FL
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Zip | 34108-1858
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Country | US
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Telephone | 239-248-8695
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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 | 364SW0102X
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Taxonomy Name | Women's Health Clinical Nurse Specialist
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License Number | 1756682
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License Number State | FL
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