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1881199396
TARA RENEE BLACKSHEAR
JACKSONVILLE, FL
NPI
1881199396
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL 9342671)
Enumeration Date
2018-03-27
Last Update Date
2023-04-04
Business Address
TARA RENEE BLACKSHEAR
655 W 8TH ST
JACKSONVILLE, FL 32209-6511
Phone number: 904-244-7118
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Mailing Address
TARA RENEE BLACKSHEAR
450077 STATE ROAD 200 STE 12
CALLAHAN, FL 32011-3863
Phone number: 904-633-0560
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