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Individual

DR. BRAD A BRISCOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN, ACNP-BC, CNS

Contact information

Practice address
3122 NEW BERLIN RD, JACKSONVILLE, FL 32226-1828
(904) 633-0340
Mailing address
653 W 8TH ST, P.O. BOX 44008, JACKSONVILLE, FL 32209-6511
(904) 244-3500
(904) 244-3425

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1067675
KY
363LA2100X
Acute Care Nurse Practitioner
Primary
2590432
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0036958-00
FL
Enumeration date
02/01/2006
Last updated
05/21/2015
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