Healthcare Provider Details

I. General information

NPI: 1982527867
Provider Name (Legal Business Name): HANNAH CARSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 BLANDING BLVD STE 102
MIDDLEBURG FL
32068-4935
US

IV. Provider business mailing address

330 CORPORATE WAY STE 200
ORANGE PARK FL
32073-6214
US

V. Phone/Fax

Practice location:
  • Phone: 904-253-7173
  • Fax: 904-265-0355
Mailing address:
  • Phone: 904-282-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11047190
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: