Individual
ELIZABETH KEENAN MCQUAGGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
400 COLONNADE DR STE 160, PONTE VEDRA, FL 32081-6236
(904) 824-1020
(904) 391-7503
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
995666
CO
363L00000X
Nurse Practitioner
Primary
APRN11014679
FL
363LF0000X
Family Nurse Practitioner
11014679
FL
363LF0000X
Family Nurse Practitioner
APRN11014679
FL
Other
Enumeration date
08/21/2020
Last updated
01/06/2023
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