Healthcare Provider Details

I. General information

NPI: 1528845054
Provider Name (Legal Business Name): JASMINE CARTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N MARKET ST # 202
JACKSONVILLE FL
32202-2802
US

IV. Provider business mailing address

25 N MARKET ST # 202
JACKSONVILLE FL
32202-2802
US

V. Phone/Fax

Practice location:
  • Phone: 904-234-0394
  • Fax:
Mailing address:
  • Phone: 904-234-0394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number9446593
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: