Individual
JENELLE C LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1325 SAN MARCO BLVD STE 200, JACKSONVILLE, FL 32207-8566
(904) 346-3465
(904) 396-0388
Mailing address
PO BOX 117345, ATLANTA, GA 30368-7345
(904) 346-3465
(904) 858-6489
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9413215
FL
363LF0000X
Family Nurse Practitioner
F339731-1
NY
Other
Enumeration date
07/21/2015
Last updated
08/10/2021
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