Individual
MS. JADE MARIE NIMMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
494 CLERMONT AVE S, ORANGE PARK, FL 32073-4337
(786) 909-9029
Mailing address
494 CLERMONT AVE S, ORANGE PARK, FL 32073-4337
(786) 909-9029
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
730396
—
FL
Enumeration date
10/08/2018
Last updated
10/08/2018
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