Individual
MRS. JESSICA BARBARA NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
12470 TELECOM DR STE 300W, TEMPLE TERRACE, FL 33637-0904
(813) 871-8200
(813) 357-5501
Mailing address
12470 TELECOM DR STE 300W, TEMPLE TERRACE, FL 33637-0904
(813) 871-8200
(813) 357-5501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9217658
FL
363LF0000X
Family Nurse Practitioner
APRN9217658
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009095300
—
FL
01
—
APRN9217658
FL LICENSE
FL
01
—
PO1992867
RAILROAD MEDICARE
FL
01
—
Y0H56
BCBS
FL
Enumeration date
02/07/2013
Last updated
03/07/2023
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