Provider Demographics
NPI:1255450953
Name:JAMPOL, MICHELLE LEE (APRN)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LEE
Last Name:JAMPOL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9401 SW DISCOVERY WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2381
Mailing Address - Country:US
Mailing Address - Phone:772-834-7362
Mailing Address - Fax:772-618-2024
Practice Address - Street 1:9401 SW DISCOVERY WAY STE 102
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2381
Practice Address - Country:US
Practice Address - Phone:772-834-7362
Practice Address - Fax:772-618-2024
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9179550363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9179550OtherNURSE PRACTITIONER