Individual
JOANN JERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 487-1764
(386) 487-1875
Mailing address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 487-1764
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP 1088012
FL
Other
Enumeration date
08/31/2006
Last updated
07/12/2007
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