Healthcare Provider Details

I. General information

NPI: 1003748054
Provider Name (Legal Business Name): JENNIFER ANNE ALLEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SHIRCLIFF WAY
JACKSONVILLE FL
32204-4748
US

IV. Provider business mailing address

95357 CORNFLOWER DR
FERNANDINA BEACH FL
32034-0179
US

V. Phone/Fax

Practice location:
  • Phone: 904-308-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number689648
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: