Provider Demographics
NPI:1427528017
Name:ALBAUGH, JESSICA (DNP, APRN, CPNP-AC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ALBAUGH
Suffix:
Gender:F
Credentials:DNP, APRN, CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 W MLK BLVD
Mailing Address - Street 2:3RD FLOOR MEDICAL ARTS BUILDING
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607
Mailing Address - Country:US
Mailing Address - Phone:813-870-4948
Mailing Address - Fax:913-554-8044
Practice Address - Street 1:3003 W MLK BLVD
Practice Address - Street 2:3RD FLOOR MEDICAL ARTS BUILDING
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-870-4948
Practice Address - Fax:913-554-8044
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11000254363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care