Provider Demographics
NPI:1407435969
Name:JEAN BAPTISTE, EMMELINE A (APRN)
Entity Type:Individual
Prefix:
First Name:EMMELINE
Middle Name:A
Last Name:JEAN BAPTISTE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SAGO CT NE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-5109
Mailing Address - Country:US
Mailing Address - Phone:863-877-9179
Mailing Address - Fax:
Practice Address - Street 1:7215 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1051
Practice Address - Country:US
Practice Address - Phone:863-452-1818
Practice Address - Fax:863-452-6544
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1407435969Medicaid