Hanley, Jennifer A

Hanley, Jennifer A is an sole proprietor health care provider with primary practice located at 2200 W Eau Gallie Blvd Ste 202B , Melbourne FL 32935-3166. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Hanley, Jennifer A can be contacted via phone (321) 254-7717.

Contact Information

Primary practice address
2200 W Eau Gallie Blvd Ste 202B Melbourne FL 32935-3166
Phone: (321) 254-7717
Fax: (321) 255-2361
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9100969 Florida

Profile Details

NPI number 1477502391
LBN Legal business name Hanley, Jennifer A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 8th, 2006
Last updated Jun 24th, 2021 - 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 1477502391 NPPES
Florida Other 9287537 AETNA PIN
Florida Other Y04UH AETNA PIN
Florida MEDICAID 290574400 AETNA PIN

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