Provider Demographics
NPI:1083031348
Name:MATHEWS, JENNIFER M (MS,CGC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:M
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:MS,CGC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:MUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CGC
Mailing Address - Street 1:2225 NW 16TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4026
Mailing Address - Country:US
Mailing Address - Phone:386-212-0893
Mailing Address - Fax:352-392-3051
Practice Address - Street 1:1600 SW ARCHER RD RM M-354
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-294-5050
Practice Address - Fax:352-392-3051
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC170300000X
170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS