Healthcare Provider Details
I. General information
NPI: 1477401388
Provider Name (Legal Business Name): CONFIDENT HEART LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6269 DAYLILLY RD
MACCLENNY FL
32063-6037
US
IV. Provider business mailing address
6269 DAYLILLY RD
MACCLENNY FL
32063-6037
US
V. Phone/Fax
- Phone: 904-699-1145
- Fax: 904-877-3368
- Phone: 904-699-1145
- Fax: 904-877-3368
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TAMEKA
DENISE
TERRY
Title or Position: OWNER
Credential: APRN
Phone: 904-699-1145