Provider Demographics
NPI:1427621101
Name:PINSON, JESSICA RENEE (APRN)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:RENEE
Last Name:PINSON
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 1:4371 VERONICA S SHOEMAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2216
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:40107 US HWY 27
Practice Address - Street 2:SUITE 200
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-5901
Practice Address - Country:US
Practice Address - Phone:863-421-9705
Practice Address - Fax:863-421-9779
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014437363L00000X
FL11014437363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology