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General NPI Number Information
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NPI Number | 1033971064
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Entity Type | Organization
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Legal Business Name | B-LEEVE PRIMARY CARE, INC
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 9570 REGENCY SQUARE BLVD STE 403
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City | JACKSONVILLE
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State | FL
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Zip | 32225-9103
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Country | US
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Telephone | 904-474-9766
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Fax | 866-531-4642
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Provider Business Mailing Address
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Address Line | 9570 REGENCY SQUARE BLVD STE 403
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City | JACKSONVILLE
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State | FL
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Zip | 32225-9103
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Country | US
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Telephone | 904-474-9766
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Fax | 866-531-4642
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Authorized Official
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Title or Position | CEO
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Name | QUAWENDELLA BAEJUHNE SKINNER
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Credential | ARNP
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Telephone | 904-239-1343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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