Provider Demographics
NPI:1407571458
Name:MARIANI, JESSICA (APRN, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:MARIANI
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7431 N UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2956
Mailing Address - Country:US
Mailing Address - Phone:954-258-9434
Mailing Address - Fax:855-594-8033
Practice Address - Street 1:7431 N UNIVERSITY DR STE 300
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2956
Practice Address - Country:US
Practice Address - Phone:954-258-9434
Practice Address - Fax:855-594-8033
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022368363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner