Individual
JASON RUNYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
13927 SHIPWRECK CIR N, JACKSONVILLE, FL 32224-1121
(904) 570-9404
(904) 379-9332
Mailing address
13927 SHIPWRECK CIR N, JACKSONVILLE, FL 32224-1121
(904) 570-9404
(904) 379-9332
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4425P
KY
363L00000X
Nurse Practitioner
Primary
ARNP9334592
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000548409
BCBS
—
01
—
3548051000
PASSPORT ADVANTAGE
KY
Enumeration date
02/22/2007
Last updated
04/11/2017
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