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General NPI Number Information
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NPI Number | 1942949797
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Entity Type | Individual
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Provider Name | JENNIFER CROSBY PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 09/30/2023
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Provider Practice Location Address
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Address Line | 6816 SOUTHPOINT PKWY STE 302
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1704
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Country | US
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Telephone | 904-527-3135
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Fax | 904-683-4293
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Provider Business Mailing Address
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Address Line | 653 W 8TH ST FL 2
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6511
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Country | US
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Telephone | 904-383-1016
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Fax | 904-244-8280
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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 | PA9115695
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License Number State | FL
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