Harry Jean, FNP-BC

Key facts

NPI

1659736767

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

ARNP 9385232 (FL)

Practice address

1021 Health Park Dr
Moore Haven, FL 33471-6206

Phone

(863) 946-0405

NPI assigned

Dec 17, 2015

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 4, 2022.

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1659736767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 JFK DR",
            "address_2": "STE B",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621153",
            "telephone_number": "561-966-7717",
            "fax_number": "888-316-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 HEALTH PARK DR",
            "city": "MOORE HAVEN",
            "state": "FL",
            "postal_code": "334716206",
            "telephone_number": "863-946-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "HARRY",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-17",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9385232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Moore Haven, FL · Family Nurse Practitioner in Florida