Provider Demographics
NPI:1396919320
Name:FILIPPONE, JAMIE LYN (APRN)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LYN
Last Name:FILIPPONE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:LYN
Other - Last Name:ALBARES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1324 LAKELAND HILLS BLVD
Mailing Address - Street 2:ATTN: MEDICAL STAFF OFFICE
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4543
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1324 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4543
Practice Address - Country:US
Practice Address - Phone:863-687-1068
Practice Address - Fax:863-687-1069
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9227522163W00000X
FLAPRN9227522363LP2300X
FLARNP9227522363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL312289100Medicaid