Individual
JESSICA JEANLOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1151 SW HALEYBERRY AVE, PORT SAINT LUCIE, FL 34953-6832
(772) 812-1426
Mailing address
1151 SW HALEYBERRY AVE, PORT SAINT LUCIE, FL 34953-6832
(772) 812-1426
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11008794
FL
Other
Enumeration date
08/21/2020
Last updated
08/11/2022
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