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Organization
MAGNOLIA FAMILY CARE CORP
Active
Organization
MAGNOLIA FAMILY CARE CORP
Active
Other names
Urolife Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYN BRYAN DNP (OWNER)
(386) 319-8938
Entity
Organization
Contact information
Practice address
256 SW PROFESSIONAL GLN STE 102, LAKE CITY, FL 32025-1104
(386) 319-8938
(386) 438-8628
Mailing address
256 SW PROFESSIONAL GLN STE 102, LAKE CITY, FL 32025-1104
(386) 319-8938
(386) 438-8628
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41469
BLUE CROSS
FL
Enumeration date
04/16/2019
Last updated
05/13/2025
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