| NPI | 1518243476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY MICHEL DAVIS Nurse Practitioner 904-993-1259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9223841) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2011-10-24 |