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General NPI Number Information
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NPI Number | 1154051571
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Entity Type | Individual
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Provider Name | REBECCA MARIE NOLES APRN
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Gender | Female
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 150 LONGLEAF PINE PKWY STE 200
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City | JACKSONVILLE
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State | FL
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Zip | 32259-7529
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Country | US
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Telephone | 904-652-0800
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Fax | 904-652-0811
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Provider Business Mailing Address
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Address Line | 4800 BELFORT RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6004
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Country | US
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Telephone | 904-398-7205
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11020006
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License Number State | FL
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