Provider Demographics
NPI:1932521127
Name:SCOTT, JESSICA LEE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LEE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:LEE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:630 PASADENA AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-2128
Mailing Address - Country:US
Mailing Address - Phone:727-345-7100
Mailing Address - Fax:727-345-7102
Practice Address - Street 1:630 PASADENA AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-2128
Practice Address - Country:US
Practice Address - Phone:727-345-7100
Practice Address - Fax:727-345-7102
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9286805363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0L8ZOtherBCBS
FLHS111YMedicare PIN