# KBN HEALTHCARE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083116107
- **Authorized official:** WENDY C LU (CREDENTIALING MANAGER)
- **Authorized official phone:** (904) 221-2535

## Contact information

- **Practice address:** 9471 BAYMEADOWS RD STE 3, JACKSONVILLE, FL 32256-7932
- **Practice address phone:** (904) 332-7431
- **Practice address fax:** (904) 332-7408
- **Mailing address:** 9471 BAYMEADOWS RD STE 3, JACKSONVILLE, FL 32256-7932
- **Mailing address phone:** (904) 332-7431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | ARNP9239957 | FL | Yes |

## Other

- **Enumeration date:** 03/05/2018
- **Last updated:** 03/05/2018