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General NPI Number Information
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NPI Number | 1992041784
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Entity Type | Individual
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Provider Name | JENNIFER LYNNE REBER ARNP, AOCNP
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Gender | Female
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Dates
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Enumeration Date | 12/24/2012
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 2987 BLACKWATER OAKS DR
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City | MULBERRY
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State | FL
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Zip | 33860-5546
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Country | US
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Telephone | 863-521-6407
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Fax |
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Provider Business Mailing Address
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Address Line | 2987 BLACKWATER OAKS DR
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City | MULBERRY
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State | FL
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Zip | 33860-5546
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Country | US
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Telephone | 863-521-6407
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN9293651
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License Number State | FL
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