Individual provider Active NPI

Jennifer Ellen Haughey, APRN

  • Family Nurse Practitioner
  • Riverview, FL
National Provider Identifier
1548969009
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11023580 Issued in FL
Practice address
11948 Balm Riverview Rd
Riverview, FL 33569-6601
Phone
(619) 244-0486
NPI assigned
Feb 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11023580 FL Primary

Addresses

Primary practice location

11948 Balm Riverview Rd
Riverview, FL 33569-6601

Mailing address

5205 Oakline View Dr
Lithia, FL 33547-4034
Phone (619) 244-0486

Other names 1

  • Jenn Ellen Haughey Other name

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

LicenseStateTypeSpecialty
11023580FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1548969009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 OAKLINE VIEW DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474034",
            "telephone_number": "619-244-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11948 BALM RIVERVIEW RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335696601",
            "telephone_number": "619-244-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGHEY",
        "first_name": "JENNIFER",
        "middle_name": "ELLEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11023580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENN",
            "last_name": "HAUGHEY",
            "middle_name": "ELLEN",
            "credential": "APRN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.