Henry, Jane Ellen

Henry, Jane Ellen is an individual health care provider with primary practice located at 580 State Road 206 West , St Augustine FL 32086. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Henry, Jane Ellen can be contacted via phone (954) 695-3643.

Contact Information

Primary practice address
580 State Road 206 West St Augustine FL 32086
Phone: (954) 695-3643
Fax: (954) 695-3643
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3000182 Florida

Profile Details

NPI number 1780658617
LBN Legal business name Henry, Jane Ellen
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Jan 24th, 2023 - about 3 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 1780658617 NPPES
Florida Other AC299 MEDICARE GROUP NUMBER
Florida Other P00381167 MEDICARE GROUP NUMBER

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