Provider Demographics
NPI:1255562922
Name:GEORGE, JENIFER SCOTT (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:JENIFER
Middle Name:SCOTT
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 SUNBEAM RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-6187
Mailing Address - Country:US
Mailing Address - Phone:904-880-0622
Mailing Address - Fax:
Practice Address - Street 1:4727 SUNBEAM RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-6187
Practice Address - Country:US
Practice Address - Phone:904-880-0622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3018122163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3018122OtherFLORIDA LICENSE