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Individual

JUDITH A JENNINGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
A.R.N.P.

Contact information

Practice address
5640 MAIN ST, NEW PORT RICHEY, FL 34652-2637
(727) 841-4425
(727) 816-1956
Mailing address
5640 MAIN ST, NEW PORT RICHEY, FL 34652-2637
(727) 841-4425
(727) 816-1956

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP1146562
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
033946600
FL
01
Y041Q
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/13/2006
Last updated
12/31/2012
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