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NPI Code Detail

MEDICARE: JENNIFER MICHELE COURSON APRN

MEDICARE:   JENNIFER MICHELE COURSON  APRN
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
1363L00000XNurse Practitioner11009061FL

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 : 1386238004
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MICHELE COURSON APRN
Provider Business Mailing Address
First Line : 9580 APPLECROSS RD STE 106
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32222-5843
Country : US
Telephone Number : 904-778-9180
Fax Number : 904-778-9740
Provider Business Practice Location Address
First Line : 9580 APPLECROSS RD STE 106
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32222-5843
Country : US
Telephone Number : 904-778-9180
Fax Number : 904-778-9740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2021
Last Update Date : 02/24/2021

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Directions to “ JENNIFER MICHELE COURSON APRN” Practice Location

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