Provider Demographics
NPI:1992553218
Name:JENNINGS, JESSICA E (CNA)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:E
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 CARIBOU CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-4202
Mailing Address - Country:US
Mailing Address - Phone:407-479-1146
Mailing Address - Fax:
Practice Address - Street 1:644 CARIBOU CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-4202
Practice Address - Country:US
Practice Address - Phone:407-591-7356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care