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Individual

MALISSA ANN KIRSTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.P.R.N.

Contact information

Practice address
6885 BELFORT OAKS PL STE 300, JACKSONVILLE, FL 32216-6284
(904) 296-4200
(904) 296-1040
Mailing address
PO BOX 25317, TAMPA, FL 33622-5317
(813) 286-0033
(813) 282-1806

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
APRN9168505
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002090000
FL
01
APRN9168505
LICENSE
FL
Enumeration date
12/05/2007
Last updated
02/27/2019
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