Provider Demographics
NPI:1356039978
Name:GREER, JENNIFER AMELIA (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AMELIA
Last Name:GREER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:AMELIA
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4300 MARSH LANDING BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-1419
Mailing Address - Country:US
Mailing Address - Phone:904-803-0113
Mailing Address - Fax:
Practice Address - Street 1:4300 MARSH LANDING BLVD STE 101
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-1419
Practice Address - Country:US
Practice Address - Phone:904-803-0113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9557456163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse