Provider Demographics
NPI:1619154150
Name:STONE, JENNIFER LYNN (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:STONE
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:SWAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2050 PARKSIDE CIR S
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-8569
Mailing Address - Country:US
Mailing Address - Phone:954-304-2488
Mailing Address - Fax:
Practice Address - Street 1:500SE17TH ST 200
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2547
Practice Address - Country:US
Practice Address - Phone:954-906-0399
Practice Address - Fax:954-906-0399
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9182895363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000670200Medicaid