MEDICARE: JENNIFER REESE SHUMAKER ACNP-BC

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	11033530	FL

General Provider Information

NPI Number	:	1740019975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER REESE SHUMAKER ACNP-BC

Provider Business Mailing Address
First Line	:	8613 OLD KINGS RD S STE 602
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4863
Country	:	US
Telephone Number	:	904-493-3390
Fax Number	:	904-493-3395

Provider Business Practice Location Address
First Line	:	8613 OLD KINGS RD S STE 602
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4863
Country	:	US
Telephone Number	:	904-493-3390
Fax Number	:	904-493-3395

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

Provider Enumeration Date	:	07/27/2024
Last Update Date	:	09/23/2025

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