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General NPI Number Information
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NPI Number | 1578834743
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Entity Type | Individual
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Provider Name | JEANNIE DEANN ATTLESEY ARNP
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Gender | Female
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 3663 BURNT PINE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0871
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Country | US
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Telephone | 904-710-4133
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Fax |
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Provider Business Mailing Address
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Address Line | 3663 BURNT PINE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0871
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Country | US
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Telephone | 904-710-4133
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Fax | 904-269-4597
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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 | ARNP3394982
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License Number State | FL
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