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Individual

MRS. JENNIFER LYNN CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1600 SW ARCHER RD, BOX 100278, GAINESVILLE, FL 32610-0278
(352) 273-7832
Mailing address
1600 SW ARCHER RD, BOX 100278, GAINESVILLE, FL 32610-0278
(352) 273-7832

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108288
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
013517000
FL
Enumeration date
08/20/2014
Last updated
08/26/2016
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