Provider Demographics
NPI:1295291227
Name:MATTHEWS, JESSICA ROSE (ARPN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ROSE
Last Name:MATTHEWS
Suffix:
Gender:
Credentials:ARPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 PINELLAS ST STE 400
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3356
Mailing Address - Country:US
Mailing Address - Phone:727-445-1991
Mailing Address - Fax:727-445-1986
Practice Address - Street 1:2357 PINELAND LN
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-4533
Practice Address - Country:US
Practice Address - Phone:407-267-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-14
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9363288163WC0200X
FL11036107363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine