JENIFER DERSTINE ARNP NPI 1386999670

NPI Information

NPI: 1386999670
Provider Name: JENIFER DERSTINE, ARNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: CONVIVA MEDICAL CENTER MANAGEMENT, LLC

PECOS Registration: Yes

Address:
1028 DUNN AVE
JACKSONVILLE, FL
ZIP 32218
Phone: (904) 766-7606
Get Directions

Jenifer Derstine, ARNP is a family nurse practitioner in Jacksonville, FL with 12 years of experience. Jenifer Derstine, ARNP NPI is 1386999670. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1028 DUNN AVE
JACKSONVILLE, FL
ZIP 32218-830
Phone: (904) 766-7606
Fax: (904) 766-7679

The NPI 1386999670 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 7/23/2012 and was last updated on 12/4/2021.

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	363LF0000X	Nurse Practitioner	Family	ARNP9203769	FLORIDA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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