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Individual

MRS. RITA JEAN LAIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.R.N.P.

Contact information

Practice address
3627 UNIVERSITY BLVD S, SUITE 200, JACKSONVILLE, FL 32216-4230
(904) 296-3200
(904) 296-0069
Mailing address
3627 UNIVERSITY BLVD S, SUITE 200, JACKSONVILLE, FL 32216-4230
(904) 296-3200
(904) 296-0069

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
ARNP 2722902
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001317500
FL
Enumeration date
07/23/2008
Last updated
06/14/2016
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