Provider Demographics
NPI:1568846624
Name:MCKEEVER, JENNIFER (AP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MCKEEVER
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 HICKORY HOLLOW DR N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-3057
Mailing Address - Country:US
Mailing Address - Phone:858-603-1955
Mailing Address - Fax:
Practice Address - Street 1:14215 SPARTINA CT STE 300
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-3232
Practice Address - Country:US
Practice Address - Phone:858-603-1955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4078171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP4078OtherACUPUNCTURE PHYSICIAN LICENSE