Provider Demographics
NPI:1255961249
Name:MINCEY, JARED DAVID (APRN, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:JARED
Middle Name:DAVID
Last Name:MINCEY
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10405 SW 122ND ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-5843
Mailing Address - Country:US
Mailing Address - Phone:352-702-2972
Mailing Address - Fax:
Practice Address - Street 1:10405 SW 122ND ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-5843
Practice Address - Country:US
Practice Address - Phone:352-702-2972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-19
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily