Individual
MICHAEL COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
13453 N MAIN ST STE 104, JACKSONVILLE, FL 32218-2773
(904) 773-4390
(941) 621-7089
Mailing address
13453 N MAIN ST STE 104, JACKSONVILLE, FL 32218-2773
(904) 773-4390
(941) 621-7089
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9262190
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN9262190
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002592800
—
FL
05
—
116312100
—
FL
01
—
SF935
MEDICARE
FL
Enumeration date
08/19/2010
Last updated
02/22/2024
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