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Individual

MRS. JENNIFER J PAUL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN CNOR CRNFA

Contact information

Practice address
16295 S. TAMIAMI TRAIL #183, FORT MYERS, FL 33908-5326
(239) 433-0035
(239) 267-5661
Mailing address
16295 S. TAMIAMI TRAIL #183, FORT MYERS, FL 33908-5326
(239) 433-0035
(239) 433-0035

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
1748502
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
310013800
FL
01
Y6478
BCBS PROVIDER NUMBER
FL
Enumeration date
01/23/2007
Last updated
02/16/2022
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