Organization
KBN HEALTHCARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY C LU (CREDENTIALING MANAGER)
(904) 221-2535
Entity
Organization
Contact information
Practice address
9471 BAYMEADOWS RD STE 3, JACKSONVILLE, FL 32256-7932
(904) 332-7431
(904) 332-7408
Mailing address
9471 BAYMEADOWS RD STE 3, JACKSONVILLE, FL 32256-7932
(904) 332-7431
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9239957
FL
Other
Enumeration date
03/05/2018
Last updated
03/05/2018
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