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Individual

JONATHAN B. DUKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Mailing address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9296738
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001805100
FL
05
115865
AL
01
592-10126
BLUE CROSS BLUE SHIELD
AL
01
G006X
BLUE CROSS BLUE SHIELD
FL
01
P00846679
MEDICARE RAILROAD
Enumeration date
01/19/2010
Last updated
11/08/2011
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