Organization
FIRST COAST COMMUNITY WELLNESS SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA JOHNSON DNP (MGR)
(904) 497-2192
Entity
Organization
Contact information
Practice address
5610 FORT CAROLINE RD, JACKSONVILLE, FL 32277-1799
(904) 374-4637
Mailing address
11712 PLEASANT CREEK DR, JACKSONVILLE, FL 32218-7566
(904) 497-2192
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
05/23/2023
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