MEDICARE: MS. JENNIFER ELLEN MERTIFF APRN FNP-C

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
1	363L00000X	Nurse Practitioner	APRN11001171	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1154986156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER ELLEN MERTIFF APRN FNP-C

Provider Business Mailing Address
First Line	:	705 WELLS RD STE 300
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-2982
Country	:	US
Telephone Number	:	904-621-0671
Fax Number	:

Provider Business Practice Location Address
First Line	:	463646 SR 200
Second Line	:	SUITE 12
City	:	YULEE
State	:	FL
Zip	:	32097-2640
Country	:	US
Telephone Number	:	904-775-3601
Fax Number	:	904-849-1919

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2019
Last Update Date	:	03/12/2026

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