Healthcare Provider Details

I. General information

NPI: 1801569454
Provider Name (Legal Business Name): HANNAH M BOSGRAAF APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SHIRCLIFF WAY STE 300
JACKSONVILLE FL
32204-4765
US

IV. Provider business mailing address

2 SHIRCLIFF WAY STE 300
JACKSONVILLE FL
32204-4765
US

V. Phone/Fax

Practice location:
  • Phone: 904-388-1820
  • Fax: 904-388-1827
Mailing address:
  • Phone: 904-388-1820
  • Fax: 904-388-1827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11047040
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number29815
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: