Witt, Jennifer Rae
Witt, Jennifer Rae is an individual health care provider with primary practice located at 150 Sw Chamber Ct Ste 101 , Port St Lucie FL 34986-3413. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Witt, Jennifer Rae can be contacted via phone (772) 301-0123.Contact Information
Primary practice address
150 Sw Chamber Ct Ste 101
Port St Lucie FL 34986-3413
Phone: (772) 301-0123
Fax: (772) 301-0124
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | APRN11008019 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 0050-1620 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 5001620 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 203964 | North Carolina |
Profile Details
| NPI number | 1629190731 |
|---|---|
| LBN Legal business name | Witt, Jennifer Rae |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 6th, 2007 |
| Last updated | Nov 7th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629190731 | NPPES |
| North Carolina | MEDICAID | 7005607 | |
| North Carolina | MEDICAID | NP3325 | |
| North Carolina | MEDICAID | 1629190731 |
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