Brody, Jennifer Butterfield

Brody, Jennifer Butterfield is an individual health care provider with primary practice located at 1651 Se Tiffany Ave , Port St Lucie FL 34952-7564. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Brody, Jennifer Butterfield can be contacted via phone (772) 398-1800.

Contact Information

Primary practice address
1651 Se Tiffany Ave Port St Lucie FL 34952-7564
Phone: (772) 398-1800
Fax: (770) 398-1815
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9108965 Florida

Profile Details

NPI number 1932561768
LBN Legal business name Brody, Jennifer Butterfield
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2016
Last updated Nov 6th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932561768 NPPES
Florida Other KHX57 FLORIDA BLUE
Florida MEDICAID 021744000 FLORIDA BLUE

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