Provider Demographics
NPI:1033475892
Name:BASS, JESSICA LOUISE (ARNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LOUISE
Last Name:BASS
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LOUISE
Other - Last Name:BROWNLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 N ORANGE AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-2381
Mailing Address - Country:US
Mailing Address - Phone:888-731-8994
Mailing Address - Fax:888-352-7383
Practice Address - Street 1:111 N ORANGE AVE STE 800
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2381
Practice Address - Country:US
Practice Address - Phone:888-731-8994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9263858363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008761600Medicaid