Provider Demographics
NPI:1336673003
Name:JEWELL, KATHERINE ARLENE (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ARLENE
Last Name:JEWELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SHIRCLIFF WAY STE 630
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4776
Mailing Address - Country:US
Mailing Address - Phone:904-308-6630
Mailing Address - Fax:904-308-5630
Practice Address - Street 1:3 SHIRCLIFF WAY STE 630
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4776
Practice Address - Country:US
Practice Address - Phone:904-308-6630
Practice Address - Fax:904-308-5630
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9218363208M00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist