Healthcare Provider Details

I. General information

NPI: 1649086661
Provider Name (Legal Business Name): KAPSULE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5178 LAKE ISABEL CT
JACKSONVILLE FL
32218-7585
US

IV. Provider business mailing address

5178 LAKE ISABEL CT
JACKSONVILLE FL
32218-7585
US

V. Phone/Fax

Practice location:
  • Phone: 904-566-9393
  • Fax:
Mailing address:
  • Phone: 904-566-9393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSICA BOWDEN
Title or Position: CEO
Credential: APRN
Phone: 904-566-9393