Provider Demographics
NPI:1285356345
Name:LAMMER, JESSELYN MISHELLE (CAA)
Entity type:Individual
Prefix:
First Name:JESSELYN
Middle Name:MISHELLE
Last Name:LAMMER
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:720 COOPER AVE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-6508
Mailing Address - Country:US
Mailing Address - Phone:352-201-9258
Mailing Address - Fax:
Practice Address - Street 1:1775 W HIBISCUS BLVD STE 215
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2627
Practice Address - Country:US
Practice Address - Phone:321-837-3820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant