Individual
JESSICA MAZZARIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5054
(850) 431-0170
Mailing address
515 MIDDLEBROOKS CIR, TALLAHASSEE, FL 32312-2352
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9186407
FL
363LN0000X
Neonatal Nurse Practitioner
Primary
APRN9186407
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001271900
—
FL
05
—
535535552E
—
GA
Enumeration date
04/06/2009
Last updated
04/10/2019
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