Healthcare Provider Details

I. General information

NPI: 1922068667
Provider Name (Legal Business Name): HESTER ELIZABETH RAIFORD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11481 OLD SAINT AUGUSTINE RD UFJP AUGUSTINE OAKS FAMILY PRACTICE CTR
JACKSONVILLE FL
32258-1402
US

IV. Provider business mailing address

PO BOX 44008 UFJP PROVIDER ENROLLMENT
JACKSONVILLE FL
32231-4008
US

V. Phone/Fax

Practice location:
  • Phone: 904-260-1818
  • Fax: 904-260-4182
Mailing address:
  • Phone: 904-244-3660
  • Fax: 904-244-3425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP389062
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP389062
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: