Doctor Name: | JENNIFER SKEETERS CRONIN |
NPI Number: | 1992148167 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | ME112755 |
Business Practice Address: | 1400 Marsh Landing Pkwy Suite 112 Jacksonville Beach, FL - 322502493 |
Business Phone Number: | 9044000283 |
Business Fax Number: | 9046777988 |
Mailing Address: | 1400 Marsh Landing Pkwy, Suite 112 JACKSONVILLE BEACH |
State: | FL |
Postal Code: | 322502493 |
Phone Number: | 9044000283 |
Fax Number: | 9046777988 |
NPI Enumeration Date: | 04/08/2013 |
NPI Last Update Date: | 08/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME112755 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |