Provider Demographics
NPI:1013303494
Name:BRANNAN, JEANNE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:
Last Name:BRANNAN
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 1:4115 SPARROW CT
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-2728
Mailing Address - Country:US
Mailing Address - Phone:813-963-2086
Mailing Address - Fax:
Practice Address - Street 1:4115 SPARROW CT
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-2728
Practice Address - Country:US
Practice Address - Phone:813-963-2086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-12
Last Update Date:2015-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9179414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily