Individual
KATHLEEN FREUDENBERGER JETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
25426 NW 166TH AVE, HIGH SPRINGS, FL 32643-1658
(561) 870-3396
Mailing address
25426 NW 166TH AVE, HIGH SPRINGS, FL 32643-1658
(561) 870-3396
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
ARNP 9179046
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305593100
—
FL
Enumeration date
12/31/2006
Last updated
02/04/2011
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