Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 9365725 | FL |
NPI | 1235281841 |
---|---|
Provider Name | Ms. Jocquelin V. Jones |
First Address | Port St Lucie, FL 34987-2405 |
Second Address | Port St Lucie, FL 34987-2405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 09/01/2015 |