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NPI Code Detail

MEDICARE: MS. JEANNINE LOUISE EVERETT ARNP

MEDICARE:  MS. JEANNINE LOUISE EVERETT  ARNP
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
1101Y00000XCounselor28140609AIN
2364S00000XClinical Nurse Specialist70000188AIN
3363LP0808XPsychiatric/Mental Health Nurse PractitionerARNP9428067FL

Other Identifiers

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

General Provider Information

NPI Number : 1083614952
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JEANNINE LOUISE EVERETT ARNP
Provider Business Mailing Address
First Line : 6 PERROTTI PL
Second Line :
City : PALM COAST
State : FL
Zip : 32164-7452
Country : US
Telephone Number : 239-936-5250
Fax Number : 239-936-9970
Provider Business Practice Location Address
First Line : 43 BARKLEY CIR
Second Line : STE. 201
City : FORT MYERS
State : FL
Zip : 33907-4510
Country : US
Telephone Number : 239-936-5250
Fax Number : 239-936-9970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 09/09/2022

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Directions to “ MS. JEANNINE LOUISE EVERETT ARNP” Practice Location

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