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NPI Code Detail

MEDICARE: JESSICA MARIE MAXWELL APRN

MEDICARE: JESSICA MARIE MAXWELL 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
1363LP0200XPediatric Nurse PractitionerARNP9265425FL

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 : 1568695898
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MARIE MAXWELL APRN
Provider Business Mailing Address
First Line : 47 5TH ST NW
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33881-4672
Country : US
Telephone Number : 866-234-8534
Fax Number :
Provider Business Practice Location Address
First Line : 106 NW 9TH AVE
Second Line :
City : MULBERRY
State : FL
Zip : 33860-2922
Country : US
Telephone Number : 866-234-8534
Fax Number : 863-683-2579
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2009
Last Update Date : 12/14/2022

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Directions to “ JESSICA MARIE MAXWELL APRN” Practice Location

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