Healthcare Provider Details

I. General information

NPI: 1326517756
Provider Name (Legal Business Name): JESSICA N MCLAUGHLIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1689 EAGLE HARBOR PKWY STE B
FLEMING ISLAND FL
32003-4817
US

IV. Provider business mailing address

705 WELLS RD STE 300
ORANGE PARK FL
32073-2982
US

V. Phone/Fax

Practice location:
  • Phone: 904-441-1111
  • Fax: 904-441-1111
Mailing address:
  • Phone: 904-621-0643
  • Fax: 904-621-0644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN9349981
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9349981
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN9349981
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN9349981
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: