Provider Demographics
NPI:1215639943
Name:VELOZA, JESSICA DIANE (APRN)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:DIANE
Last Name:VELOZA
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 1:3273 LORD MURPHY TRL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-1757
Mailing Address - Country:US
Mailing Address - Phone:850-510-2648
Mailing Address - Fax:
Practice Address - Street 1:2200 S MONROE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-6303
Practice Address - Country:US
Practice Address - Phone:850-354-8765
Practice Address - Fax:850-900-5941
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11025238363LF0000X, 202D00000X, 2083B0002X, 363L00000X, 363LF0000X
FLRN9343337163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner