Provider Demographics
NPI:1134802994
Name:ROSENMARKLE, JESSICA (PNP-PC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ROSENMARKLE
Suffix:
Gender:F
Credentials:PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5868 CREEK STATION DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8627
Mailing Address - Country:US
Mailing Address - Phone:850-471-5060
Mailing Address - Fax:850-471-5070
Practice Address - Street 1:2390 ANTIGUA CT
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-2554
Practice Address - Country:US
Practice Address - Phone:850-530-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018654363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics