Jennifer C Eziefuoh, APRN

Individual provider Active NPI Nurse Practitioner · Bradenton, FL

NPI 1013481787 · NPPES record last updated Jan 16, 2019

Key facts

NPI
1013481787
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
APRN (FL)
Practice address
8610 State Road 70 E
Bradenton, FL 34202-3785
Phone
(941) 242-1929
Fax
(941) 242-5116
NPI assigned
Jan 16, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
APRNFLMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN FL Yes

Addresses

Primary practice location

8610 State Road 70 E
Bradenton, FL 34202-3785

Mailing address

8610 State Road 70 E
Bradenton, FL 34202-3785
Phone (941) 242-1929

Other providers in Bradenton, FL

All providers in Bradenton, FL · Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.