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Individual

JENNIFER EAGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM, ARNP

Contact information

Practice address
3801 S KANNER HWY, STUART, FL 34994-4801
(772) 419-3301
Mailing address
701 BROOKEDGE TER, SEBASTIAN, FL 32958-6114
(253) 514-1070

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
APRN11024601
FL
367A00000X
Advanced Practice Midwife
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1710384235
WA
Enumeration date
11/26/2014
Last updated
09/19/2023
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