Healthcare Provider Details

I. General information

NPI: 1740799097
Provider Name (Legal Business Name): LAURA DENISE CODRINGTON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2017
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7406 FULLERTON ST STE 200
JACKSONVILLE FL
32256-3597
US

IV. Provider business mailing address

7401 NW 14TH ST
PLANTATION FL
33313-5931
US

V. Phone/Fax

Practice location:
  • Phone: 904-538-0440
  • Fax:
Mailing address:
  • Phone: 954-465-3247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9349784
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: