Individual
COURTNEY GRACE VINYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
15255 MAX LEGGETT PKWY STE 4900, JACKSONVILLE, FL 32218-7273
(904) 244-3406
(904) 244-3840
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-3406
(904) 244-3840
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11017495
FL
363LF0000X
Family Nurse Practitioner
AP61005365
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2158141
—
WA
Enumeration date
11/19/2019
Last updated
02/28/2023
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