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General NPI Number Information
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NPI Number | 1427858778
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Entity Type | Individual
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Provider Name | MS. SAMANTHA JACKSON-OATES
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Gender | Female
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 8659 BAYPINE RD BLDG 3
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7577
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Country | US
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Telephone | 904-730-2200
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Fax | 800-687-6731
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Provider Business Mailing Address
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Address Line | 9112 COUNTRY MILL LN
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City | JACKSONVILLE
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State | FL
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Zip | 32222-1419
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Country | US
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Telephone | 904-554-0102
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Fax | 904-554-0102
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11037728
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License Number State | FL
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