Provider Demographics
NPI:1891404984
Name:SIO, JESSICA STEPHANIE (PMHNP, ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:STEPHANIE
Last Name:SIO
Suffix:
Gender:F
Credentials:PMHNP, ARNP
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:STEPHANIE
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP, ARNP
Mailing Address - Street 1:2506 W 70TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6443
Mailing Address - Country:US
Mailing Address - Phone:305-905-4970
Mailing Address - Fax:
Practice Address - Street 1:7990 SW 117TH AVE STE 132
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-3845
Practice Address - Country:US
Practice Address - Phone:786-294-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023093363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health