1962712851 NPI number — MS. JENNIFER LYNN MCNALLY ARNP

Table of content: MS. JENNIFER LYNN MCNALLY ARNP (NPI 1962712851)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962712851 NPI number — MS. JENNIFER LYNN MCNALLY ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCNALLY
Provider First Name:
JENNIFER
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962712851
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7300 SW 62ND PLACE
Provider Second Line Business Mailing Address:
THIRD FLOOR
Provider Business Mailing Address City Name:
SOUTH MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33143
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-665-1133
Provider Business Mailing Address Fax Number:
305-666-0258

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7300 SW 62ND PLACE
Provider Second Line Business Practice Location Address:
THIRD FLOOR
Provider Business Practice Location Address City Name:
SOUTH MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-665-1133
Provider Business Practice Location Address Fax Number:
305-666-0258
Provider Enumeration Date:
10/14/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  ARNP9218876 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com