Provider Demographics
NPI:1396113197
Name:MARTINEZ, JESSICA ELENA (ARNP)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:ELENA
Last Name:MARTINEZ
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 1:8540 HOMEPLACE DR APT 1429
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-1933
Mailing Address - Country:US
Mailing Address - Phone:305-798-8675
Mailing Address - Fax:
Practice Address - Street 1:8540 HOMEPLACE DRIVE APT 1429
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256
Practice Address - Country:US
Practice Address - Phone:305-798-8675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9295676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily