Provider Demographics
NPI:1639840762
Name:MAECKER, JENNIFER (AP)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:MAECKER
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 WOOD ST STE 115
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-7926
Mailing Address - Country:US
Mailing Address - Phone:941-499-7775
Mailing Address - Fax:
Practice Address - Street 1:2033 WOOD ST STE 115
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-7926
Practice Address - Country:US
Practice Address - Phone:941-499-7775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4281171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist