Provider Demographics
NPI:1568866622
Name:COVINGTON, GINA RENEE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:RENEE
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:GINA
Other - Middle Name:RENEE
Other - Last Name:MOSSALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:19096 SE HOMEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33469-1639
Mailing Address - Country:US
Mailing Address - Phone:723-213-7347
Mailing Address - Fax:
Practice Address - Street 1:601 BROOKER CREEK BLVD
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-2962
Practice Address - Country:US
Practice Address - Phone:561-267-2138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-18
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9309601363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily