Provider Demographics
NPI:1891161808
Name:MCGLONE, JESSICA NICOLE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:NICOLE
Last Name:MCGLONE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:NICOLE
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:4948 REFLECTING POND CIR
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-4064
Mailing Address - Country:US
Mailing Address - Phone:727-519-6431
Mailing Address - Fax:
Practice Address - Street 1:520 N FALKENBURG RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7884
Practice Address - Country:US
Practice Address - Phone:727-519-6431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV873025363L00000X
FL9389135363LF0000X
AL3-001540363LF0000X
CO0004233-C-NP363LF0000X
IAA176865363LF0000X
KS53-82123-082363LF0000X
KY3010300363LF0000X
MI4704409832363LF0000X
MS905650363LF0000X
NC5019254363LF0000X
OHAPRN.CNP.0035173363LF0000X
OR10019512363LF0000X
VA24188775363LF0000X
WAAP61498536363LF0000X
AZ301827363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner