Provider Demographics
NPI:1417043555
Name:NIXON, JENNIFER (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:NIXON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAY PINES VA HEALTHCARE SYSTEM
Mailing Address - Street 2:10000 BAY PINES BLVD
Mailing Address - City:BAY PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33744
Mailing Address - Country:US
Mailing Address - Phone:727-398-6661
Mailing Address - Fax:727-319-1184
Practice Address - Street 1:10000 BAY PINES BLVD
Practice Address - Street 2:
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744-8200
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-319-1184
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT47296364405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily