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NPI Code Detail

MEDICARE: JORDYN ROSE GILL APRN

MEDICARE:   JORDYN ROSE GILL  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
1363LF0000XFamily Nurse PractitionerAPRN11033907FL
2363LF0000XFamily Nurse Practitioner11033907FL

General Provider Information

NPI Number : 1619714003
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDYN ROSE GILL APRN
Provider Business Mailing Address
First Line : 2401 GATHERING WAY
Second Line :
City : ODESSA
State : FL
Zip : 33556-4382
Country : US
Telephone Number : 908-328-4765
Fax Number :
Provider Business Practice Location Address
First Line : 2803 W SAINT ISABEL ST
Second Line :
City : TAMPA
State : FL
Zip : 33607-6343
Country : US
Telephone Number : 813-253-2273
Fax Number : 813-253-2279
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2024
Last Update Date : 12/10/2024

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Directions to “ JORDYN ROSE GILL APRN” Practice Location

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