Provider Demographics
NPI:1699727115
Name:GICHIA, JANNIE E (CNM, ARNP)
Entity type:Individual
Prefix:MS
First Name:JANNIE
Middle Name:E
Last Name:GICHIA
Suffix:
Gender:F
Credentials:CNM, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:515 W 6TH ST
Mailing Address - Street 2:MC #24
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32206-4324
Mailing Address - Country:US
Mailing Address - Phone:904-665-2410
Mailing Address - Fax:904-253-2508
Practice Address - Street 1:5150 TIMUQUANA RD
Practice Address - Street 2:SUITE 9
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-8959
Practice Address - Country:US
Practice Address - Phone:904-253-1120
Practice Address - Fax:904-253-2508
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP1162982367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306538300Medicaid