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General NPI Number Information
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NPI Number | 1639649841
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Entity Type | Individual
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Provider Name | NICOLE PARR ARNP
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Gender | Female
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 3599 UNIVERSITY BLVD S STE 104
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4200
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Country | US
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Telephone | 904-724-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 2844 POST ST
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City | JACKSONVILLE
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State | FL
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Zip | 32205-7414
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Country | US
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Telephone | 305-319-0336
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 9291011
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9291011
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License Number State | FL
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