Provider Demographics
NPI:1992041784
Name:REBER, JENNIFER LYNNE (ARNP, AOCNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNNE
Last Name:REBER
Suffix:
Gender:F
Credentials:ARNP, AOCNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNNE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP, AOCNP
Mailing Address - Street 1:2987 BLACKWATER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MULBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:33860-5546
Mailing Address - Country:US
Mailing Address - Phone:863-521-6407
Mailing Address - Fax:
Practice Address - Street 1:2987 BLACKWATER OAKS DR
Practice Address - Street 2:
Practice Address - City:MULBERRY
Practice Address - State:FL
Practice Address - Zip Code:33860-5546
Practice Address - Country:US
Practice Address - Phone:863-521-6407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-24
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9293651363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1992041784OtherNPI