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Individual

JESSICA HERRAIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
2222 S HARBOR CITY BLVD, STE 610, MELBOURNE, FL 32901-5591
(321) 723-7716
(321) 541-1581
Mailing address
2222 S HARBOR CITY BLVD, STE 610, MELBOURNE, FL 32901-5591
(321) 723-7716
(321) 541-1581

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11006608
FL
363LA2100X
Acute Care Nurse Practitioner
RN301203
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
108097000
FL
Enumeration date
06/12/2013
Last updated
03/09/2021
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