Provider Demographics
NPI:1023634003
Name:NEAL, JAMIE LEANN (APRN, CNM)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEANN
Last Name:NEAL
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 BLANDING BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-1946
Mailing Address - Country:US
Mailing Address - Phone:904-379-2540
Mailing Address - Fax:904-379-2541
Practice Address - Street 1:5500 BLANDING BLVD STE 1
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-1946
Practice Address - Country:US
Practice Address - Phone:904-379-2540
Practice Address - Fax:904-379-2541
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007377367A00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife