Provider Demographics
NPI:1548435530
Name:PARRA, JENNIFER HERNANDEZ (APRN-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HERNANDEZ
Last Name:PARRA
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 NW 82ND AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6682
Mailing Address - Country:US
Mailing Address - Phone:305-689-1910
Mailing Address - Fax:
Practice Address - Street 1:3650 NW 82ND AVE STE 302
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6682
Practice Address - Country:US
Practice Address - Phone:305-689-1910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9180116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily