Provider Demographics
NPI:1780317065
Name:METAYER, MARISE-JASMINE C (FNP)
Entity type:Individual
Prefix:MRS
First Name:MARISE-JASMINE
Middle Name:C
Last Name:METAYER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3285 EL CAMINO REAL
Mailing Address - Street 2:NA
Mailing Address - City:WEST PALM
Mailing Address - State:FL
Mailing Address - Zip Code:33409
Mailing Address - Country:US
Mailing Address - Phone:561-628-1658
Mailing Address - Fax:
Practice Address - Street 1:3285 EL CAMINO REAL
Practice Address - Street 2:NA
Practice Address - City:WEST PALM
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:561-628-1658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020418363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily