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Contact Information

5JAGHEALTH, PLLC
112 IRVIN AVE SW
LIVE OAK, FL32064-2214
 Phone: 386-647-6144
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for 5JAGHEALTH PLLC · (Female)

NPI Number 1407636582
Status Active
Credentials
Entity Individual
Enumeration date 10/04/2023
Last updated 02/08/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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