Provider Demographics
NPI:1396296174
Name:PULLAPPALLY, JASMIN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JASMIN
Middle Name:
Last Name:PULLAPPALLY
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 1:2602 QUEEN ALBERTA DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-6526
Mailing Address - Country:US
Mailing Address - Phone:727-252-9849
Mailing Address - Fax:
Practice Address - Street 1:2602 QUEEN ALBERTA DR
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6526
Practice Address - Country:US
Practice Address - Phone:727-252-9849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7173207P00000X
FL9271387363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine