Individual
JENNIFER FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, NP-C
Contact information
Practice address
3333 W 20TH ST, JACKSONVILLE, FL 32254-1703
(904) 695-9145
(904) 695-2465
Mailing address
PO BOX 19249, JACKSONVILLE, FL 32245-9249
(904) 743-1883
(904) 743-5309
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
9464978
FL
163W00000X
Registered Nurse
170984
TN
363LF0000X
Family Nurse Practitioner
16095
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
9464978
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9464978
FL
Other
Enumeration date
03/16/2012
Last updated
02/28/2022
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