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Individual

MS. JENNIFER R MALOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(850) 862-1111
Mailing address
40 MAGNOLIA AVE, SHALIMAR, FL 32579-1110
(850) 259-0980

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN9362106
FL
363L00000X
Nurse Practitioner
Primary
APRN11023716
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
APRN11023716
FL BOARD OF NURSING
FL
Enumeration date
11/07/2022
Last updated
12/28/2022
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