Bloodworth, Jennifer Marie

Bloodworth, Jennifer Marie is an individual health care provider with primary practice located at 5270 Babcock St Ne Suite 1, Palm Bay FL 32905-8630. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bloodworth, Jennifer Marie can be contacted via phone (321) 722-5959.

Contact Information

Primary practice address
5270 Babcock St Ne Suite 1 Palm Bay FL 32905-8630
Phone: (321) 722-5959
Fax: (321) 722-5960
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9310812 Florida

Profile Details

NPI number 1639479900
LBN Legal business name Bloodworth, Jennifer Marie
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2010
Last updated Aug 18th, 2015 - about 11 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 1639479900 NPPES
Florida MEDICAID 003241600

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