MEDICARE: KRISTEN PRESCOTT APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11005355	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	OF065	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023494275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN PRESCOTT APRN

Provider Business Mailing Address
First Line	:	232 SEAMIST CT
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-4039
Country	:	US
Telephone Number	:	812-525-9685
Fax Number	:

Provider Business Practice Location Address
First Line	:	4815 SWEETGRASS PL UNIT 201
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-0131
Country	:	US
Telephone Number	:	904-367-3373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2015
Last Update Date	:	02/16/2026

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Directions to “ KRISTEN PRESCOTT APRN” Practice Location

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