Provider Demographics
NPI:1669049375
Name:CROPPER, JODY MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:MICHELLE
Last Name:CROPPER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10985 SW COUNTY ROAD 240
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32024-4613
Mailing Address - Country:US
Mailing Address - Phone:765-524-8771
Mailing Address - Fax:
Practice Address - Street 1:340 NW COMMERCE DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-4709
Practice Address - Country:US
Practice Address - Phone:386-759-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9311817163WE0003X
FLAPRN11013990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency