Provider Demographics
NPI:1912556051
Name:HESSE, JENAE MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:JENAE
Middle Name:MICHELLE
Last Name:HESSE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3305
Mailing Address - Country:US
Mailing Address - Phone:727-895-5210
Mailing Address - Fax:727-821-4297
Practice Address - Street 1:116 1ST ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3305
Practice Address - Country:US
Practice Address - Phone:727-895-5210
Practice Address - Fax:727-821-4297
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO66529163W00000X
KS13-140598-122163W00000X
FLAPRN11018677363L00000X
KS79276363L00000X
NC5014240363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner