Skip Navigation

Provider Information for 1750770442

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

MS. JENNIE LYNN WILSON ARNP

Gender: FEMALE

Individual NPI: 1750770442

Calendar   Last Updated:  2020-08-06
  Certification Date:  2020-08-06

Details

Name Value
NPI 1750770442
Enumeration Date 2015-01-18
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 2919 W SWANN AVE STE 400A
TAMPA, FL 33609-4082
United States

Phone: 813-871-2959 | Fax: 813-877-8891
View Map External Link
Primary Practice Address 2919 W SWANN AVE STE 400A
TAMPA, FL 33609-4082
United States

Phone: 813-871-2959 | Fax: 813-877-8891
View Map External Link
Secondary Practice Address 26838 TANIC DR
WESLEY CHAPEL, FL 33544-4617
United States

Phone: 813-991-4000 | Fax:
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 363LF0000X - Nurse Practitioner Family FL 2881212