Individual
CHARLOTTE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1681 EAGLE HARBOR PKWY STE B, FLEMING ISLAND, FL 32003-4819
(904) 644-0092
(904) 644-0099
Mailing address
PO BOX 551308, JACKSONVILLE, FL 32255-1308
(904) 622-9040
(904) 309-5691
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN11002748
FL
Other
Enumeration date
10/09/2019
Last updated
10/11/2019
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