Provider Demographics
NPI:1629510599
Name:WALDON, JENNIFER SALLY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SALLY
Last Name:WALDON
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3627 UNIVERSITY BLVD S STE 305
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4294
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3627 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 615
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4230
Practice Address - Country:US
Practice Address - Phone:904-398-9334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2022-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9109980363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant