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NPI Code Detail

MEDICARE: JESSICA ROSE TEETERS MSN, APRN, FNP-C

MEDICARE: JESSICA ROSE TEETERS MSN, APRN, FNP-C
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
1363LF0000XFamily Nurse Practitioner11008653FL

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 : 1306457957
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ROSE TEETERS MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 3294 W MALLORY BLVD
Second Line :
City : JUPITER
State : FL
Zip : 33458-8771
Country : US
Telephone Number : 561-339-2868
Fax Number :
Provider Business Practice Location Address
First Line : 11000 N MILITARY TRL
Second Line :
City : PALM BEACH GARDENS
State : FL
Zip : 33410-6504
Country : US
Telephone Number : 561-626-7542
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2020
Last Update Date : 05/12/2021

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