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NPI Code Detail

MEDICARE: KACI HOLLENBACHER THOMAS

MEDICARE: KACI HOLLENBACHER THOMAS
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
1163W00000XRegistered NurseRN9567768FL

General Provider Information

NPI Number : 1053245829
Entity Type Code : Individual
Provider Name (Legal Business Name) : KACI HOLLENBACHER THOMAS
Provider Business Mailing Address
First Line : 2350 RIVER PARK TRCE
Second Line :
City : GREEN COVE SPRINGS
State : FL
Zip : 32043-5115
Country : US
Telephone Number : 904-719-0351
Fax Number :
Provider Business Practice Location Address
First Line : 4500 SAN PABLO RD S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-1865
Country : US
Telephone Number : 904-953-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2026
Last Update Date : 06/09/2026

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Directions to “ KACI HOLLENBACHER THOMAS ” Practice Location

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