Provider Demographics
NPI:1568604940
Name:PROFESSIONAL RN FIRST ASSISTANTS, P.A.
Entity Type:Organization
Organization Name:PROFESSIONAL RN FIRST ASSISTANTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:RN CNDR CRNFA
Authorized Official - Phone:239-433-0035
Mailing Address - Street 1:16295 S. TAMIAMI TRAIL #183
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-5326
Mailing Address - Country:US
Mailing Address - Phone:239-433-0035
Mailing Address - Fax:239-433-0035
Practice Address - Street 1:16295 S. TAMIAMI TRAIL #183
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-5326
Practice Address - Country:US
Practice Address - Phone:239-433-0035
Practice Address - Fax:239-267-5661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 1748502163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty