Active NPI
Judy Maynor Comeaux, ARNP
- Pediatric Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1871786665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- ARNP 1615762
- Practice address
- 810 Lane Ave S
Jacksonville, FL 32205-4785 - Phone
- (904) 783-9680
- Fax
- (904) 693-0138
- NPI assigned
- Aug 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | ARNP 1615762 | FL | Primary |
Addresses
Primary practice location
810 Lane Ave S
Jacksonville, FL 32205-4785
Mailing address
810 Lane Ave S
Jacksonville, FL 32205-4785
Phone (904) 783-9680
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 1615762 | FL | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187913600000",
"number": "1871786665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 LANE AVE S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322054785",
"telephone_number": "904-783-9680",
"fax_number": "904-693-0138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 LANE AVE S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322054785",
"telephone_number": "904-783-9680",
"fax_number": "904-693-0138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMEAUX",
"first_name": "JUDY",
"middle_name": "MAYNOR",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-24",
"last_updated": "2007-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "ARNP 1615762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.