Individual
MRS. JENNIFER RENEE MASTER BOATWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
27343 WESLEY CHAPEL BLVD, WESLEY CHAPEL, FL 33544-4287
(813) 991-9355
(813) 355-5031
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(813) 528-4975
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9107775
FL
363AM0700X
Medical Physician Assistant
Primary
PA9107775
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014578600
—
FL
01
—
P01483687
RR MEDICARE
—
Enumeration date
10/26/2007
Last updated
12/17/2021
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