Individual
KELLY SUTHER EUBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9183840
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9183840
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007430-00
—
FL
05
—
468126999A
—
GA
05
—
468126999F
—
GA
Enumeration date
12/11/2008
Last updated
06/19/2015
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