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NPI Code Detail

MEDICARE: JENNIFER MAE PRESCOTT FNP

MEDICARE: JENNIFER MAE PRESCOTT FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse200841268RNOR
2163W00000XRegistered Nurse363330CA
3163W00000XRegistered NurseRN138280AZ
4163W00000XRegistered NurseR076739AR
5163W00000XRegistered NurseRN9504028FL
6363L00000XNurse PractitionerA002911AR
7363L00000XNurse PractitionerR0131163OK
8363L00000XNurse Practitioner200850065NPOR
9363L00000XNurse PractitionerAPRN11001195FL
10363LP2300XPrimary Care Nurse PractitionerAP2369AZ
11363L00000XNurse PractitionerNP9805CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023039575
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MAE PRESCOTT FNP
Provider Business Mailing Address
First Line : PO BOX 6094
Second Line :
City : CAREFREE
State : AZ
Zip : 85377-6094
Country : US
Telephone Number : 480-404-7220
Fax Number :
Provider Business Practice Location Address
First Line : 14355 MIRANDA WAY
Second Line :
City : LOS ALTOS HILLS
State : CA
Zip : 94022-2032
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 05/07/2025

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