Provider Demographics
NPI:1922766187
Name:SADLER, JENNIFER JOSEPHINE (APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOSEPHINE
Last Name:SADLER
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 1:1207 SHOTONA CT
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-6174
Mailing Address - Country:US
Mailing Address - Phone:813-570-2986
Mailing Address - Fax:
Practice Address - Street 1:1207 SHOTONA CT
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6174
Practice Address - Country:US
Practice Address - Phone:813-570-2986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11016066207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine