Anderson, Jessica Dawn

Anderson, Jessica Dawn is an individual health care provider with primary practice located at 4315 Highland Park Blvd , Lakeland FL 33813-1639. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Anderson, Jessica Dawn can be contacted via phone (863) 255-4777.

Contact Information

Primary practice address
4315 Highland Park Blvd Lakeland FL 33813-1639
Phone: (863) 255-4777
Fax: (863) 940-4856
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X ARNP9213300 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN9213300 Florida

Profile Details

NPI number 1942655592
LBN Legal business name Anderson, Jessica Dawn
Credentials ARNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2016
Last updated Mar 9th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942655592 NPPES
Florida Other IU868Z MEDICAID
Florida MEDICAID 017604000 MEDICAID

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