Jennifer M Holland

Individual provider Active NPI Personal Care Attendant · Jay, FL

NPI 1982168514 · NPPES record last updated Jan 28, 2019

Key facts

NPI
1982168514
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
2707 Bud Diamond Rd
Jay, FL 32565-4846
Phone
(850) 398-3961
NPI assigned
Jan 28, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant
Group: 193400000X SINGLE SPECIALTY GROUP
3747P1801X Yes

Addresses

Primary practice location

2707 Bud Diamond Rd
Jay, FL 32565-4846

Mailing address

2707 Bud Diamond Rd
Jay, FL 32565-4846
Phone (850) 398-3961

Other practice location 1

2707 Bud Diamond Rd
Jay, FL 32565-4846
Phone (850) 398-3961

Other providers in Jay, FL

All providers in Jay, FL · Personal Care Attendant in Florida

Sources for this page

Verify at the official NPI Registry.