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General NPI Number Information
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NPI Number | 1518693712
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Entity Type | Individual
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Provider Name | JONATHAN CURTIS DENEAU APRN
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Gender | Male
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Dates
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Enumeration Date | 07/28/2022
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 801 E 6TH ST STE 606
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City | PANAMA CITY
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State | FL
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Zip | 32401-3645
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Country | US
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Telephone | 850-913-6960
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Fax |
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Provider Business Mailing Address
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Address Line | 4205 BELFORT RD STE 4015
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City | JACKSONVILLE
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State | FL
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Zip | 32216-3623
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Country | US
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Telephone | 904-450-6063
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Fax | 904-539-4091
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN11020915
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License Number State | FL
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