Individual
AMANDA B PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
3 SHIRCLIFF WAY, SUITE 714, JACKSONVILLE, FL 32204-4757
(904) 308-2006
(904) 308-7111
Mailing address
3599 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4252
(904) 345-7776
(904) 345-7772
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
9349014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01118046
RAILROAD MEDICARE
FL
01
—
Y0E3S
BCBS-FL
FL
Enumeration date
08/30/2012
Last updated
02/11/2021
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