Provider Demographics
NPI:1134001902
Name:MARSTON, JENNIFER P
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:P
Last Name:MARSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18331 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1421
Mailing Address - Country:US
Mailing Address - Phone:786-718-8683
Mailing Address - Fax:786-513-6245
Practice Address - Street 1:18331 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1421
Practice Address - Country:US
Practice Address - Phone:786-718-8683
Practice Address - Fax:786-513-6245
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11040511363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health