| Doctor Name: | MRS. JENNIFER L SIEGEL |
| NPI Number: | 1033454731 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 9204294 |
| Business Practice Address: | 445 S Lawrence Blvd Suite A Keystone Heights, FL - 326569222 |
| Business Phone Number: | 3525627927 |
| Business Fax Number: | 7703191019 |
| Mailing Address: | 445 S Lawrence Blvd, Suite A KEYSTONE HEIGHTS |
| State: | FL |
| Postal Code: | 326569222 |
| Phone Number: | 3525627927 |
| Fax Number: | 7703191019 |
| NPI Enumeration Date: | 12/06/2012 |
| NPI Last Update Date: | 07/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 9204294 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |