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Individual
JESSICA MATTINGLY
Active
Individual
JESSICA MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
9436706
FL
363L00000X
Nurse Practitioner
Primary
APRN11002976
FL
363LF0000X
Family Nurse Practitioner
11002976
FL
Other
Enumeration date
05/29/2019
Last updated
11/18/2022
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