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NPI Code Detail

MEDICARE: JESSICA HUNNICUTT APRN

MEDICARE: JESSICA HUNNICUTT APRN
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 NurseRN.398722OH
2163WP0808XPsychiatric/Mental Health Registered NurseRN9555444FL
3363LP0808XPsychiatric/Mental Health Nurse Practitioner11011640FL
4101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1215315452
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA HUNNICUTT APRN
Provider Business Mailing Address
First Line : 400 EAST SHERIDAN RD
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-3184
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 E SHERIDAN RD
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-3184
Country : US
Telephone Number : 321-722-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2015
Last Update Date : 06/21/2022

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