Provider Demographics
NPI:1588162770
Name:KINNER, JENNA (FNP-C)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:KINNER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 N KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4741
Mailing Address - Country:US
Mailing Address - Phone:407-539-2766
Mailing Address - Fax:
Practice Address - Street 1:237 WHITE ST STE 1
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6351
Practice Address - Country:US
Practice Address - Phone:910-577-4968
Practice Address - Fax:910-577-2916
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN180957163W00000X
AZAP11243363LF0000X
NC5011585363LF0000X
FLAPRN11011964363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse