Individual provider Active NPI

Edith Jean, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1033967294
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11032108 Issued in FL
Practice address
8570 Granite CT Ste 101
Fort Myers, FL 33908-4240
Phone
(833) 769-3524
Fax
(239) 256-7516
NPI assigned
May 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11032108 FL Primary

Addresses

Primary practice location

8570 Granite CT Ste 101
Fort Myers, FL 33908-4240

Mailing address

8570 Granite CT Ste 101
Fort Myers, FL 33908-4240
Phone (833) 769-3524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240522003014 FL Practitioner - Nurse Practitioner 0648612671 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

8570 Granite CT
Suite 101
Fort Myers, FL 33908-4102
Phone (239) 310-4646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11032108FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hni Medical Services of Florida, LLC Nurse Practitioner CurrentSince Nov 24, 2024 Accepting new patients
Personal Recovery Network LLC CurrentSince Mar 17, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

8570 Granite Ct
Ste 101
Fort Myers, FL 33908
Phone (239) 310-4646

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.edithjean@141363.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1033967294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8570 GRANITE CT STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084240",
            "telephone_number": "833-769-3524",
            "fax_number": "239-256-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8570 GRANITE CT STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084240",
            "telephone_number": "833-769-3524",
            "fax_number": "239-256-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "EDITH",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-10",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11032108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.