Individual
JACKLINE LINDA MUMIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1542 KINGSLEY AVE STE 136-137, ORANGE PARK, FL 32073-4586
(904) 458-7780
Mailing address
1542 KINGSLEY AVE STE 136-137, ORANGE PARK, FL 32073-4586
(904) 458-7780
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11036814
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11036814
FL
Other
Enumeration date
02/11/2025
Last updated
03/27/2026
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