Provider Demographics
NPI:1295732311
Name:AERTKER, JEAN H (DNP, ARNP)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:H
Last Name:AERTKER
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 WEST SWANN AVENUE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609
Mailing Address - Country:US
Mailing Address - Phone:813-414-9400
Mailing Address - Fax:813-414-9401
Practice Address - Street 1:2919 W SWANN AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4038
Practice Address - Country:US
Practice Address - Phone:813-414-9400
Practice Address - Fax:813-414-9401
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1065822363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health