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NPI Code Detail

MEDICARE: JESSICA S MAGNALDI NURSE PRACTITIONER

MEDICARE: JESSICA S MAGNALDI NURSE PRACTITIONER
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
1363LA2200XAdult Health Nurse Practitioner11011428FL

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 : 1558965194
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA S MAGNALDI NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 140 6TH AVE
Second Line :
City : INDIALANTIC
State : FL
Zip : 32903-3204
Country : US
Telephone Number : 321-312-3501
Fax Number :
Provider Business Practice Location Address
First Line : 140 6TH AVE
Second Line :
City : INDIALANTIC
State : FL
Zip : 32903-3204
Country : US
Telephone Number : 321-312-3501
Fax Number : 321-723-9176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2020
Last Update Date : 05/05/2023

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