| Doctor Name: | MS. CONNIE ANN JONGEWAARD |
| NPI Number: | 1164795746 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, ARNP, FNP-BC |
| License Number: | ARNP3269412 |
| Business Practice Address: | 209 Ponte Vedra Park Dr Ponte Vedra Beach, FL - 320826600 |
| Business Phone Number: | 9042736200 |
| Business Fax Number: | 9042736100 |
| Mailing Address: | 209 Ponte Vedra Park Dr, PONTE VEDRA BEACH |
| State: | FL |
| Postal Code: | 320826600 |
| Phone Number: | 9042736200 |
| Fax Number: | 9042736100 |
| NPI Enumeration Date: | 02/13/2012 |
| NPI Last Update Date: | 02/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP3269412 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |