Individual provider Active NPI

Jessica Alicia Maynor, DNP, APRN

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1780501940
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11046552 Issued in FL
Practice address
3696 Peninsula Cir
Melbourne, FL 32940-1113
Phone
(912) 409-6002
NPI assigned
Jun 30, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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 APRN11046552 FL Primary

Addresses

Primary practice location

3696 Peninsula Cir
Melbourne, FL 32940-1113

Mailing address

3696 Peninsula Cir
Melbourne, FL 32940-1113
Phone (912) 409-6002

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

NPI Registry JSON

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

{
    "created_epoch": "1782777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1780501940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3696 PENINSULA CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401113",
            "telephone_number": "912-409-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3696 PENINSULA CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401113",
            "telephone_number": "912-409-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNOR",
        "first_name": "JESSICA",
        "middle_name": "ALICIA",
        "credential": "DNP, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-30",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11046552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.