Individual
DR. NANCY P. MENDENHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2015 JEFFERSON ST, JACKSONVILLE, FL 32206-3531
(904) 588-1263
Mailing address
PO BOX 116304, ATLANTA, GA 30368-6304
(904) 588-1263
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME39054
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000415632E
—
GA
05
—
0686042-00
—
FL
05
—
068604200
—
FL
01
—
920006634
RAILROAD MEDICARE
FL
Enumeration date
04/01/2006
Last updated
12/13/2011
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