Individual
KAREN HEAVNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14546 OLD SAINT AUGUSTINE RD, SUITE 107, JACKSONVILLE, FL 32258-5468
(904) 352-2466
(904) 352-2472
Mailing address
14546 OLD SAINT AUGUSTINE RD, SUITE 107, JACKSONVILLE, FL 32258-5468
(904) 352-2466
(904) 352-2472
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1791572
FL
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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