Provider Demographics
NPI:1609608686
Name:DESPUJOS, JENNY PATRICIA SR (APRN)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:PATRICIA
Last Name:DESPUJOS
Suffix:SR
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 1:131 S FEDERAL HWY APT 432
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-4951
Mailing Address - Country:US
Mailing Address - Phone:786-651-1058
Mailing Address - Fax:
Practice Address - Street 1:131 S FEDERAL HWY APT 432
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-4951
Practice Address - Country:US
Practice Address - Phone:786-651-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-17
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034745363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily