Individual
ELIZABETH ANN SECRIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-4677
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-4677
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-01612
NC
363A00000X
Physician Assistant
Primary
PA9105404
FL
Other
Enumeration date
12/19/2008
Last updated
08/17/2012
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