Individual
KIM MARIE MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3627 UNIVERSITY BLVD S STE 305, JACKSONVILLE, FL 32216-4294
(904) 593-0760
(904) 398-1729
Mailing address
3627 UNIVERSITY BLVD S STE 305, JACKSONVILLE, FL 32216-4294
(904) 593-0760
(904) 398-1729
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9171791
FL
363LA2200X
Adult Health Nurse Practitioner
ARNP9171791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137439A
—
GA
05
—
003137439B
—
GA
05
—
009463500
—
FL
Enumeration date
08/28/2013
Last updated
06/02/2022
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