Provider Demographics
NPI:1619609138
Name:ANDRADE, JESSICA MARIA (APRN FNP-BC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIA
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W COLONIAL DR STE 303
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6863
Mailing Address - Country:US
Mailing Address - Phone:904-745-3618
Mailing Address - Fax:904-722-4271
Practice Address - Street 1:6484 FORT CAROLINE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-2042
Practice Address - Country:US
Practice Address - Phone:904-744-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11019978363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily