Faison, Jennifer Elizabeth

Faison, Jennifer Elizabeth is an individual health care provider with primary practice located at 1690 Dunlawton Avenue Suite 210, Port Orange FL 32127-8980. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Faison, Jennifer Elizabeth can be contacted via phone (386) 763-4920.

Contact Information

Primary practice address
1690 Dunlawton Avenue Suite 210 Port Orange FL 32127-8980
Phone: (386) 763-4920
Fax: (386) 763-4939
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9104338 Florida

Profile Details

NPI number 1902088586
LBN Legal business name Faison, Jennifer Elizabeth
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2007
Last updated Jul 26th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902088586 NPPES
Florida Other PA9104338 MEDICAL LICENSE

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