MEDICARE: VANESSA JONES BRISCOE APRN, 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	363LG0600X	Gerontology Nurse Practitioner	APRN9374796	FL
2	163WG0000X	General Practice Registered Nurse	RN9374796	FL

General Provider Information

NPI Number	:	1942408570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA JONES BRISCOE APRN, BC

Provider Business Mailing Address
First Line	:	PO BOX 40549
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-1256
Country	:	US
Telephone Number	:	904-281-1915
Fax Number	:	904-281-1119

Provider Business Practice Location Address
First Line	:	5011 GATE PKWY BLDG 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0830
Country	:	US
Telephone Number	:	904-281-1915
Fax Number	:	904-281-1119

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

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	02/06/2026

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