Provider Demographics
NPI:1851050371
Name:JETTON, ANNE MARIE (MSN, APRN, AGPC-C)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:JETTON
Suffix:
Gender:F
Credentials:MSN, APRN, AGPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2253 GOLDENROD ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5318
Mailing Address - Country:US
Mailing Address - Phone:941-266-1922
Mailing Address - Fax:
Practice Address - Street 1:2253 GOLDENROD ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5318
Practice Address - Country:US
Practice Address - Phone:941-266-1922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11016487363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care