Individual
JACOB KIE WU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5992 BERRYHILL RD STE 302, MILTON, FL 32570-1017
(850) 416-4620
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6063
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9479917
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN11009848
FL
Other
Enumeration date
03/31/2019
Last updated
02/17/2021
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