Provider Demographics
NPI:1609363084
Name:PRIEST, JESSICA LYNNE (DNP, ARNP, AGNP)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LYNNE
Last Name:PRIEST
Suffix:
Gender:F
Credentials:DNP, ARNP, AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 NW 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8789
Mailing Address - Country:US
Mailing Address - Phone:561-512-7090
Mailing Address - Fax:
Practice Address - Street 1:7300 DEL PRADO CIR S
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3386
Practice Address - Country:US
Practice Address - Phone:561-329-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9266873363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner