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General NPI Number Information
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NPI Number | 1851706014
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Entity Type | Individual
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Provider Name | SHELLEY SEGAL JONES
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Gender | Female
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 06/26/2014
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Provider Practice Location Address
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Address Line | 325 CLYDE MORRIS BLVD STE 390
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City | ORMOND BEACH
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State | FL
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Zip | 32174-8179
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Country | US
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Telephone | 386-425-4450
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Fax | 386-425-4451
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Provider Business Mailing Address
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Address Line | 303 N CLYDE MORRIS BLVD # 10E PBFS DEPT
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2709
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Country | US
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Telephone | 386-254-4000
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Fax | 386-226-3371
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | ARNP1727542
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License Number State | FL
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