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General NPI Number Information
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NPI Number | 1508834631
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Entity Type | Individual
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Provider Name | JENNIFER SUE MATTHEWS PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 204 ROCKCREEK DR
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City | SAINT JOHNS
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State | FL
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Zip | 32259-3280
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Country | US
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Telephone | 800-469-9031
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Fax | 949-695-4231
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Provider Business Mailing Address
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Address Line | 204 ROCKCREEK DR
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City | SAINT JOHNS
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State | FL
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Zip | 32259-3280
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Country | US
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Telephone | 904-352-9957
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Fax | 904-204-1470
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9103372
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License Number State | FL
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