Provider Demographics
NPI:1922509504
Name:FILOSA, JESSICA ANDREA (FNP, CNM)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANDREA
Last Name:FILOSA
Suffix:
Gender:F
Credentials:FNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 KINGSLEY AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-9200
Mailing Address - Country:US
Mailing Address - Phone:904-264-1628
Mailing Address - Fax:
Practice Address - Street 1:1560 KINGSLEY AVE STE 4
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-9200
Practice Address - Country:US
Practice Address - Phone:904-264-1628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95079119163W00000X
FLAPRN11003279363LF0000X, 363LP2300X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care