Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | APRN9344303 | FL |
N | 363L00000X | Nurse Practitioner | APRN9344303 | FL |
N | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9344303 | FL |
NPI | 1124544861 |
---|---|
Provider Name | Miss Sarah Nicole Stanley |
First Address | Jacksonville, FL 32256-0532 |
Second Address | Jacksonville, FL 32207-8426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2017 |
Last Update Date | 09/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023111900 | (05) | FL |