5JAGHEALTH, PLLC

NPI 1407636582 Active Nurse Practitioner, Family

Quick Facts

NPI Number

1407636582

Type

Organization (NPI-2)

Status

Active

Enumeration Date

2023-10-04

Last Updated (NPPES)

2024-02-08

Primary Specialty / Taxonomy

Taxonomy	Nurse Practitioner, Family
Taxonomy Code	`363LF0000X`

Other Taxonomies

Family Medicine

Practice Address

112 IRVIN AVE SW
LIVE OAK, FL 320642214

Phone: 386-647-6144

Mailing Address

8405 127TH DR
LIVE OAK, FL 320608835

Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.