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General NPI Number Information
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NPI Number | 1669084604
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Entity Type | Individual
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Provider Name | JENNIFER LYNN WHITE APRN
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Gender | Female
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 841 PRUDENTIAL DR STE 1900
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8373
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Country | US
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Telephone | 863-738-0027
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Fax |
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Provider Business Mailing Address
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Address Line | 8940 SW 76TH AVE
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City | GAINESVILLE
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State | FL
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Zip | 32608-8750
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Country | US
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Telephone | 863-738-0027
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 11007907
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License Number State | FL
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