Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN11010448 | FL |
NPI | 1033710371 |
---|---|
Provider Name | Stacy Jones |
First Address | Mount Dora, FL 32757-6751 |
Second Address | Mount Dora, FL 32757-6751 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2020 |
Last Update Date | 08/12/2020 |