Individual
HANNAH JACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1600 SW ARCHER RD STE 4102, GAINESVILLE, FL 32610-3003
(352) 265-0239
(352) 265-1107
Mailing address
PO BOX 100265, GAINESVILLE, FL 32610-0265
(352) 265-0239
(352) 265-1107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9112430
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104363800
—
FL
Enumeration date
08/02/2019
Last updated
10/18/2019
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