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NPI Code Detail

MEDICARE: JESSICA JANE HANLEY

MEDICARE:   JESSICA JANE HANLEY
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1083126858
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA JANE HANLEY
Provider Business Mailing Address
First Line : 3205 PARTRIDGE POINT TRL
Second Line :
City : VALRICO
State : FL
Zip : 33596-7936
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3205 PARTRIDGE POINT TRL
Second Line :
City : VALRICO
State : FL
Zip : 33596-7936
Country : US
Telephone Number : 813-727-2715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2017
Last Update Date : 11/01/2017

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Directions to “ JESSICA JANE HANLEY ” Practice Location

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