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General NPI Number Information
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NPI Number | 1043981418
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Entity Type | Individual
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Provider Name | JENNIFER HINES
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Gender | Female
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Dates
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Enumeration Date | 09/24/2021
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 4011 NW 43RD ST STE B
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City | GAINESVILLE
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State | FL
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Zip | 32606-4609
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Country | US
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Telephone | 866-253-6681
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Fax |
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Provider Business Mailing Address
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Address Line | 16649 NW 166TH DR
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City | ALACHUA
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State | FL
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Zip | 32615-4996
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Country | US
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Telephone | 352-262-2510
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | APRN11014857
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License Number State | FL
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