Provider Demographics
NPI:1023495801
Name:BURKETT, JESSICA (ARNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BURKETT
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 1:3627 UNIVERSITY BLVD S
Mailing Address - Street 2:STE 255
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4230
Mailing Address - Country:US
Mailing Address - Phone:904-396-4666
Mailing Address - Fax:
Practice Address - Street 1:2600 LAKE LUCIEN DR STE 112
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7233
Practice Address - Country:US
Practice Address - Phone:321-207-9029
Practice Address - Fax:844-410-7960
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9303822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily