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Individual

DAVIS BRENT HART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSN

Contact information

Practice address
14546 OLD SAINT AUGUSTINE RD STE 409, JACKSONVILLE, FL 32258-5473
(904) 388-6518
(904) 384-1005
Mailing address
PO BOX 746647, ATLANTA, GA 30374-6647
(904) 202-2092
(904) 376-4075

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN9406598
FL
363L00000X
Nurse Practitioner
Primary
APRN11026732
FL
363LF0000X
Family Nurse Practitioner
APRN11026732
FL

Other

Enumeration date
03/10/2023
Last updated
02/04/2025
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