Active NPI
Jennifer Lynne Stufflebeam
- Gerontology Nurse Practitioner
- Naples, FL
National Provider Identifier
1063184539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 11015557
- Practice address
- 101 Wading Bird Cir Apt 202
Naples, FL 34110-9200 - Phone
- (407) 538-0914
- NPI assigned
- Oct 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 11015557 | FL | Primary |
Addresses
Primary practice location
101 Wading Bird Cir Apt 202
Naples, FL 34110-9200
Mailing address
101 Wading Bird Cir Apt 202
Naples, FL 34110-9200
Phone (407) 538-0914
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11015557 | FL | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633046400000",
"number": "1063184539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 WADING BIRD CIR APT 202",
"city": "NAPLES",
"state": "FL",
"postal_code": "341109200",
"telephone_number": "407-538-0914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WADING BIRD CIR APT 202",
"city": "NAPLES",
"state": "FL",
"postal_code": "341109200",
"telephone_number": "407-538-0914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUFFLEBEAM",
"first_name": "JENNIFER",
"middle_name": "LYNNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-01",
"last_updated": "2021-10-01",
"certification_date": "2021-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "FL",
"license": "11015557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.