Provider Demographics
NPI:1730139452
Name:SHEU, JENNIFER (NURSE PRACTIONER)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SHEU
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11201 CAMPFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-3905
Mailing Address - Country:US
Mailing Address - Phone:626-675-4555
Mailing Address - Fax:
Practice Address - Street 1:5150 BELFORT RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6026
Practice Address - Country:US
Practice Address - Phone:904-296-0900
Practice Address - Fax:904-296-7597
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9221932174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist