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Provider Information for 1306351929

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

JESSICA KOKICH ARNP

Gender: FEMALE

Individual NPI: 1306351929

Calendar   Last Updated:  2017-12-05
  Certification Date: 

Details

Name Value
NPI 1306351929
Enumeration Date 2017-12-05
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 38135 MARKET SQ
ZEPHYRHILLS, FL 33542-7505
United States

Phone: 352-567-0188 | Fax: 813-355-5101
View Map External Link
Primary Practice Address 38135 MARKET SQ
ZEPHYRHILLS, FL 33542-7505
United States

Phone: 813-778-0444 | Fax: 813-355-5017
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 193200000X MULTI-SPECIALTY GROUP
363LF0000X - Nurse Practitioner Family
FL ARNP9321604