Provider Demographics
NPI:1013015973
Name:KOSKINEN, JENNIFER L (APRN, CNM)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:KOSKINEN
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:KNAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:737 N APOPKA VINELAND RD STE 500
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-7204
Mailing Address - Country:US
Mailing Address - Phone:407-630-5300
Mailing Address - Fax:
Practice Address - Street 1:737 N APOPKA VINELAND RD STE 500
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-7204
Practice Address - Country:US
Practice Address - Phone:407-630-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT208367A00000X
FL11029051367A00000X
CT001104363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11029051OtherAPRN
CT1013015973Medicaid