MEDICARE: MS. JENNIFER KEESE SCHANTZ CNM

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	367A00000X	Advanced Practice Midwife	9457444	FL

General Provider Information

NPI Number	:	1568448751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER KEESE SCHANTZ CNM

Provider Business Mailing Address
First Line	:	1015 ATLANTIC BLVD STE 264
Second Line	:
City	:	ATLANTIC BEACH
State	:	FL
Zip	:	32233-3313
Country	:	US
Telephone Number	:	360-607-6765
Fax Number	:

Provider Business Practice Location Address
First Line	:	2104 MASSEY AVE
Second Line	:	BUILDING 2104
City	:	JACKSONVILLE
State	:	FL
Zip	:	32228
Country	:	US
Telephone Number	:	904-270-4270
Fax Number	:

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

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	03/10/2025

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