Provider Demographics
NPI:1477849206
Name:LUFKIN, JEANNE MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:MARIE
Last Name:LUFKIN
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 1:12470 TELECOM DR
Mailing Address - Street 2:STE 100
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0904
Mailing Address - Country:US
Mailing Address - Phone:813-915-5459
Mailing Address - Fax:855-225-2817
Practice Address - Street 1:17511 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3211
Practice Address - Country:US
Practice Address - Phone:813-915-5459
Practice Address - Fax:855-225-2817
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2632532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily