Individual
KATARINA A DEVAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9324546
FL
363LF0000X
Family Nurse Practitioner
9324546
FL
363LF0000X
Family Nurse Practitioner
ARNP9324546
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016143900
—
FL
Enumeration date
11/03/2015
Last updated
11/02/2021
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