Organization
DNS WAIVER SUPPORT COORDINATOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH NURSE-SELLERS (OWNER)
(904) 729-9770
Entity
Organization
Contact information
Practice address
4451 MARSH HAWK DR S, JACKSONVILLE, FL 32218-9173
(904) 729-9770
Mailing address
4451 MARSH HAWK DR S, JACKSONVILLE, FL 32218-9173
(904) 729-9770
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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