RENUKA JACKSON (NPI# 1093330714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093330714 |
| Entity Type | Individual |
| Full Name | RENUKA JACKSON |
| Other Name | RENUKA PUNWASI |
| Practice Address |
6150 Diamond Centre Ct Unit 100 Fort Myers FL 33912-4367 |
| Practice Telephone | 2395619191 |
| Mailing Telephone | 2395619191 |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2020-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 11007300 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6150 DIAMOND CENTRE CT UNIT 100 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33912-4367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134684814 | Performance Health Surgery Center | Clinic/Center | 9500 Gulf Research Lane, Fort Myers, FL 33912 | 2019-02-06 |
| 1609351899 | Voa Lee County Health Care Facility, Inc. | Skilled Nursing Facility | 14750 Hope Center Loop, Ft. Myers, FL 33912 | 2018-10-03 |
| 1245719954 | Lauren Grimes | Pharmacist | 13711 S Tamiami Trail, Fort Myers, FL 33912 | 2018-08-13 |
| 1972080828 | Solaris Rehab, LLC | Clinic/Center | 14001 Metro Parkway, Fort Myers, FL 33912 | 2018-07-24 |
| 1467943803 | Marie Veronica Scott | Nurse Practitioner | 14015 Danpak Loop, Fort Myers, FL 33912 | 2018-05-22 |
| 1952892291 | Daniels Modern Dentistry, Pa | Dentist | 6871 Daniels Parkway, Suite 100, Fort Myers, FL 33912 | 2018-05-22 |
| 1295258994 | Julie Ann Jakobi | Counselor | 18 Quanery Court, Fort Myers, FL 33912 | 2017-07-25 |
| 1205359908 | Maria Reyes | Developmental Therapist | 8961 Daniels Center Drive Suite 401, Fort Myers, FL 33912 | 2017-07-25 |
| 1669919288 | Darinka Ruiz | Social Worker | 961 Daniels Center Drive, Suite 401, Fort Myers, FL 33912 | 2017-01-20 |
| 1730622598 | Valerie Starnes | Nurse Practitioner | 13411 Parker Commons Blvd Ste 101, Fort Myers, FL 33912 | 2016-11-28 |
| Find all providers in zip 33912 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386101798 | Debra Lee Sicilian | Nurse Practitioner | 2327 Jeffcott St, Fort Myers, FL 33901-5211 | 2019-02-22 |
| 1619452877 | Kamila Shurii Tursi | Nurse Practitioner | 6631 Orion Dr Ste 110, Fort Myers, FL 33912-4333 | 2018-10-03 |
| 1003396714 | Carmalee Martin | Nurse Practitioner | 9341 Via San Giovani St, Fort Myers, FL 33905-5564 | 2018-08-21 |
| 1740779701 | Dedra Dawn Coop | Nurse Practitioner | 13300 S Cleveland Ave Ste 56, Fort Myers, FL 33907-3871 | 2018-05-05 |
| 1073039087 | Ruth Milien Jonathas | Nurse Practitioner | 16420 Healthpark Commons Dr Ste 100, Fort Myers, FL 33908-9621 | 2017-08-21 |
| 1396283578 | Jerry Hernandez Sr. | Nurse Practitioner | 12731 World Plaza Ln Bldg 83, Fort Myers, FL 33907-4081 | 2017-02-07 |
| 1730622598 | Valerie Starnes | Nurse Practitioner | 13411 Parker Commons Blvd Ste 101, Fort Myers, FL 33912 | 2016-11-28 |
| 1942752134 | Lauren Chandler Masters | Nurse Practitioner | 14300 Riva Del Lago Dr Apt 704, Fort Myers, FL 33907-7804 | 2016-11-04 |
| 1467706192 | Kerry Spillane | Nurse Practitioner | 9981 S. Healthpark Dr, Fort Myers, FL 33908-3618 | 2012-11-02 |
| 1972872679 | Evelyn S Perez | Nurse Practitioner | 13685 Doctor's Way, Suite 310, Fort Myers, FL 33912-4300 | 2011-12-26 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33912 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.