Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JENNIFER R JACK, CPNP
ActiveJENNIFER R JACK, CPNP is a Pediatric Nurse Practitioner healthcare provider located in FORT MYERS, Florida. NPI 1184045148 is currently active in the NPPES registry. Verify at CMS.
Pediatric Nurse Practitioner · FORT MYERS, FL
Registration Details
- NPI Number
- 1184045148
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 18, 2013 (12.613046914173 yrs)
- Last Updated
- May 3, 2022
- Licenses
-
28148319A (IN)71004791A (IN)APRN11019090 (FL)
Practice Information
- Address
-
15901 BASS RD STE 102FORT MYERS, FL, 339083838Browse FL providers · Browse ZIP 33908
- Phone
- 2393439890
- Fax
- 2393439898
- Primary Specialty
-
Pediatric Nurse Practitioner
363LP0200X
- Additional Specialty
- Pediatric Nurse Practitioner
- Additional Specialty
- Pediatric Nurse Practitioner
Other Pediatric Nurse Practitioner Providers in FORT MYERS, FL
| Name | Credential | NPI |
|---|---|---|
| MRS. SUSAN MARIE MALLONE-STEAD | APRN | 1487658316 |
| KORI ANN HOWELL SMITH | APRN | 1427045491 |
| CHRISTINE MONICA CLAUSE | ARNP | 1699766725 |
| MR. COREY BRIAN FRITZ | ACPNP | 1982666145 |
| SHARON OSINSKI | APRN | 1326057191 |
| MRS. LISA CHRISTINE ROMANO | A.P.N.,C. | 1720267859 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.