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Individual
MISS JENNIFER LYNN MOORE
Active
Individual
MISS JENNIFER LYNN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 9106682
FL
363A00000X
Physician Assistant
PA9106682
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9106682
FL LICENSE
FL
Enumeration date
09/06/2012
Last updated
01/02/2025
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