Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW424 | FL |
NPI | 1083375638 |
---|---|
Provider Name | Jessica Joyce Lakey |
First Address | Jacksonville, FL 32204-3521 |
Second Address | Jacksonville, FL 32204-3521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2022 |
Last Update Date | 05/01/2022 |