Provider Demographics
NPI:1588073654
Name:BAUMANN, JESSICA BETH (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:BETH
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:BETH
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33601-1289
Mailing Address - Country:US
Mailing Address - Phone:813-660-6950
Mailing Address - Fax:813-660-6622
Practice Address - Street 1:5 TAMPA GENERAL CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3601
Practice Address - Country:US
Practice Address - Phone:813-660-6950
Practice Address - Fax:813-660-6622
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9310066363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9310066Medicaid
FLARNP9310066Medicaid
FLARNP9310066Medicare UPIN