Jane Ellen Henry, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3000182 Issued in FL

Practice address

580 State Road 206 West
St Augustine, FL 32086

Phone

(954) 695-3643

Fax

(954) 695-3643

NPI assigned

Feb 15, 2006

Last updated

Jan 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1780658617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 STATE ROAD 206 WEST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "954-695-3643",
            "fax_number": "954-695-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 STATE ROAD 206 WEST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "954-695-3643",
            "fax_number": "954-695-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JANE",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3000182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "AC299",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00381167",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Henke
• Dustin Stephen Henneka, MSW
• Stephen William Henneka, L.C.S.W.
• Christopher Hans Henry, DMD MS PC
• Holly Jo Henry, R.D.
• Joshua Michael Henry, MD
• Diana Hensley
• Ryan P Hentkowski, PA-C
• Zoltan Hepp
• Urszula Herbert, PA-C

• Family Nurse Practitioner in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Family Nurse Practitioner in Florida

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