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NPI Code Detail

MEDICARE: JASON ALLEN

MEDICARE: JASON ALLEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN9351773FL
2363LF0000XFamily Nurse PractitionerAPRN9351773FL
3363LP2300XPrimary Care Nurse PractitionerAPRN9351773FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023557386
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON ALLEN
Provider Business Mailing Address
First Line : 6817 SOUTHPOINT PKWY STE 203
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-6286
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6817 SOUTHPOINT PKWY STE 203
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-6286
Country : US
Telephone Number : 904-330-1024
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2017
Last Update Date : 02/13/2019

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Directions to “ JASON ALLEN ” Practice Location

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