Provider Demographics
NPI:1679345276
Name:TAYON, JESSICA LINDSEY (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LINDSEY
Last Name:TAYON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14347 BARRACUDA RUN
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0527
Mailing Address - Country:US
Mailing Address - Phone:954-319-0474
Mailing Address - Fax:
Practice Address - Street 1:3021 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-3300
Practice Address - Country:US
Practice Address - Phone:135-268-8811
Practice Address - Fax:135-268-6947
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029254363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily