Provider Demographics
NPI:1275007577
Name:OSPINA, JESSICA ELLEN (APRN-C)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ELLEN
Last Name:OSPINA
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33601-1289
Mailing Address - Country:US
Mailing Address - Phone:813-660-7100
Mailing Address - Fax:
Practice Address - Street 1:2211 LITHIA CENTER LN
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-5676
Practice Address - Country:US
Practice Address - Phone:813-660-7100
Practice Address - Fax:813-660-6625
Is Sole Proprietor?:No
Enumeration Date:2019-01-20
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily