Provider Demographics
NPI:1871301010
Name:KIRKEY, JESSICA RAE (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAE
Last Name:KIRKEY
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:RAE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-468-0324
Mailing Address - Fax:239-908-7117
Practice Address - Street 1:19511 HIGHLAND OAKS DR STE 201
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-9712
Practice Address - Country:US
Practice Address - Phone:239-468-0324
Practice Address - Fax:239-908-7117
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL125231500Medicaid