Individual
PATRICIA ANN JAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
7820 N ARMENIA AVE, TAMPA, FL 33604-3852
(813) 935-6060
(813) 933-8096
Mailing address
15604 EASTBOURN DR, ODESSA, FL 33556-2850
(813) 920-3664
(813) 920-3491
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
ARNP1397802
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP1397802
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307911200
—
FL
01
—
692094200
MEDICAID WAIVER
FL
Enumeration date
09/20/2006
Last updated
12/29/2008
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