Provider Demographics
NPI:1972509628
Name:JENNINGS, ALINDA JEAN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ALINDA
Middle Name:JEAN
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 SW 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-5468
Mailing Address - Country:US
Mailing Address - Phone:561-395-1363
Mailing Address - Fax:
Practice Address - Street 1:1601 CLINT MOORE RD
Practice Address - Street 2:SUITE 170
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2768
Practice Address - Country:US
Practice Address - Phone:561-939-0900
Practice Address - Fax:561-939-0909
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP331932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277422OtherAVMED INSURANCE PROVIDER#