Provider Demographics
NPI:1467481119
Name:CANFIELD, JENNIFER E (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:E
Last Name:CANFIELD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:800 GOODLETTE RD STE 340
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5412
Practice Address - Country:US
Practice Address - Phone:239-206-1625
Practice Address - Fax:239-214-8838
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2742972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304305300Medicaid
FL40916BOtherBLUE CROSS
FLY0598OtherBLUE SHIELD
FL40916BOtherBLUE CROSS