Provider Demographics
NPI:1861643462
Name:FLIGHT, JENNIFER NATHALIE
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:NATHALIE
Last Name:FLIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZOE
Other - Middle Name:
Other - Last Name:FLIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LM, CPM
Mailing Address - Street 1:1901 SE 12TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32641-8750
Mailing Address - Country:US
Mailing Address - Phone:352-275-8131
Mailing Address - Fax:
Practice Address - Street 1:810 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5507
Practice Address - Country:US
Practice Address - Phone:352-372-4784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL221176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife