Healthcare Provider Details

I. General information

NPI: 1447001888
Provider Name (Legal Business Name): JEHMIA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 STOCKTON ST
JACKSONVILLE FL
32204-3521
US

IV. Provider business mailing address

7845 PARADISE ISLAND BLVD
JACKSONVILLE FL
32256-3780
US

V. Phone/Fax

Practice location:
  • Phone: 904-990-3619
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW457
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: