Provider Demographics
NPI:1194386094
Name:KLEMME ZAIAC, JERI LYNN (APRN, FNP-C,PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JERI
Middle Name:LYNN
Last Name:KLEMME ZAIAC
Suffix:
Gender:F
Credentials:APRN, FNP-C,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 BELLE MEADE ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-5247
Mailing Address - Country:US
Mailing Address - Phone:305-632-3963
Mailing Address - Fax:305-757-7323
Practice Address - Street 1:861 BELLE MEADE ISLAND DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-5247
Practice Address - Country:US
Practice Address - Phone:305-632-3963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-22
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11000398363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily