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Individual

JESICA CLEVELAND ARCHIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN

Contact information

Practice address
1720 S ORANGE AVE, ORLANDO, FL 32806-2945
(407) 540-1000
(407) 540-1011
Mailing address
1720 S ORANGE AVE, ORLANDO, FL 32806-2945
(407) 540-1000
(407) 540-1011

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
4317
SC
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN9497670
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
105761900
FL
01
4317
APRN LICENSE NUMBER
SC
Enumeration date
10/20/2010
Last updated
04/30/2020
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