Individual
JESSICA MARIE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
106 NW 9TH AVE, MULBERRY, FL 33860-2922
(866) 234-8534
(863) 683-2579
Mailing address
47 5TH ST NW, WINTER HAVEN, FL 33881-4672
(866) 234-8534
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9265425
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001465200
—
FL
Enumeration date
09/03/2009
Last updated
12/14/2022
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