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Individual

MRS. HAYLEY GANT PATRIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
14540 OLD SAINT AUGUSTINE RD STE 2593, JACKSONVILLE, FL 32258-7420
(904) 328-5289
(904) 328-1690
Mailing address
1824 KING ST STE 200, JACKSONVILLE, FL 32204-4736
(904) 384-3343
(904) 400-6671

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9109035
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9109035
FL

Other

Enumeration date
09/22/2015
Last updated
03/31/2025
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