JENNIFER DAWN CLYATT APRN AGNP-C NPI 1073179602

NPI Information

NPI: 1073179602
Provider Name: JENNIFER DAWN CLYATT, APRN, AGNP-C
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
2237 LITHIA CENTER LN
VALRICO, FL
ZIP 33596
Phone: (813) 662-0123
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Jennifer Dawn Clyatt, APRN, AGNP-C is a gerontology nurse practitioner in Valrico, FL with 8 years of experience. Jennifer Dawn Clyatt, APRN, AGNP-C NPI is 1073179602. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2237 LITHIA CENTER LN
VALRICO, FL
ZIP 33596-676
Phone: (813) 662-0123
Fax: (813) 662-9422

The NPI 1073179602 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/20/2019 and was last updated on 1/3/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	APRN1101024	FLORIDA	No
2	363LG0600X	Nurse Practitioner	Gerontology	APRN11001024	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	APRN11001024	OTHER	FLORIDA	MED LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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