Provider Demographics
NPI:1003673054
Name:GERMAIN, JENNIFER APHRODITE (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:APHRODITE
Last Name:GERMAIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 N 53RD AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3922
Mailing Address - Country:US
Mailing Address - Phone:305-450-8698
Mailing Address - Fax:
Practice Address - Street 1:1920 N 53RD AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3922
Practice Address - Country:US
Practice Address - Phone:305-450-8698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009555363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care