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Individual

JACOB EDWARD SHELLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ARNP

Contact information

Practice address
5153 N 9TH AVE STE 305, PENSACOLA, FL 32504-5719
(850) 416-6159
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6014
(904) 450-6401

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9375373
FL

Other

Enumeration date
06/28/2018
Last updated
04/27/2020
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