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General NPI Number Information
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NPI Number | 1477371466
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Entity Type | Individual
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Provider Name | HANNAH LAYNE NELSON FNP
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Gender | Female
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 4495 ROOSEVELT BLVD STE 403
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City | JACKSONVILLE
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State | FL
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Zip | 32210-3384
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Country | US
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Telephone | 904-929-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 11830 BUCKFIELD CIR APT 4204
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0017
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Country | US
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Telephone | 678-588-5130
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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 | RN269692
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License Number State | GA
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