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NPI Code Detail

MEDICARE: JILL M HUNTZINGER NP-C

MEDICARE: JILL M HUNTZINGER NP-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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner11001933FL
2363LF0000XFamily Nurse PractitionerAPRN.CNP.020464OH

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

General Provider Information

NPI Number : 1336686534
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL M HUNTZINGER NP-C
Provider Business Mailing Address
First Line : 9683 IBIS GROVE BLVD
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33545-2279
Country : US
Telephone Number : 419-215-3320
Fax Number :
Provider Business Practice Location Address
First Line : 6750 N ANDREWS AVE STE 200
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33309-2180
Country : US
Telephone Number : 800-275-3243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2017
Last Update Date : 08/07/2023

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