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Individual

MRS. JENNIFER M AINSWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Mailing address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-092761
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9244135
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009910639
AL
01
051540490
BC OF AL
AL
05
110188
AL
05
308135400
FL
01
592-07279
BLUE CROSS BLUE SHIELD
AL
01
G4122
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/14/2006
Last updated
06/26/2009
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