Provider Demographics
NPI:1932768710
Name:KIKIC, JASMINA (CRNA)
Entity Type:Individual
Prefix:
First Name:JASMINA
Middle Name:
Last Name:KIKIC
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JASMINA
Other - Middle Name:
Other - Last Name:KESEROVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4408 85TH AVENUE CIR E
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-1906
Mailing Address - Country:US
Mailing Address - Phone:502-541-3549
Mailing Address - Fax:
Practice Address - Street 1:560 JACKSON ST N STE 200
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1449
Practice Address - Country:US
Practice Address - Phone:727-820-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1138439390200000X
FLAPRN11008856367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program