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Jessica Mattingly

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

PECOS Enrollment

Based on the most recent information from CMS, provider Jessica Mattingly is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 8 days ago.

Profile Details

Provider ID
1093373771
Provider Type
Individual
Full Name
Mattingly, Jessica
Credential
APRN

Gender
Female
Sole Proprietor
No
Enumeration Date
5/29/2019
Last Updated
11/18/2022

Contact Information

Practice Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Mailing Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License APRN11002976 Florida
Code 163WE0003X	Description Registered Nurse Nursing Service Providers	License 9436706 Florida
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 11002976 Florida

Jessica Mattingly

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Dehr, Lindsay Mychael

Fields, Pamela Dawn

Cardona, Kathryn

Neeson, Lynn

Ayer, Faith Elizabeth

Schivelbein, Ashley Ann

Frauenheim, Kristina Lea

Rogers, Emily Rose

Edwards, Steven

Myatt, Kaitlin Marie