Provider Demographics
NPI:1184016453
Name:VICENS, JANNELLE (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JANNELLE
Middle Name:
Last Name:VICENS
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:MISS
Other - First Name:JANNELLE
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:PO BOX 743144
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3144
Mailing Address - Country:US
Mailing Address - Phone:786-596-2000
Mailing Address - Fax:
Practice Address - Street 1:8900 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2118
Practice Address - Country:US
Practice Address - Phone:786-527-6000
Practice Address - Fax:786-814-4283
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9394363363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9394363OtherARNP
NY689346OtherRN LICENSE