Provider Demographics
NPI:1932899820
Name:PEARCY, JENNIFER SUZANNE (APRN, CNM/WHNP-BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUZANNE
Last Name:PEARCY
Suffix:
Gender:F
Credentials:APRN, CNM/WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6072 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-5072
Mailing Address - Country:US
Mailing Address - Phone:850-626-5447
Mailing Address - Fax:
Practice Address - Street 1:6072 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-5072
Practice Address - Country:US
Practice Address - Phone:850-626-5447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022740367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife