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General NPI Number Information
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NPI Number | 1881958783
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Entity Type | Individual
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Provider Name | HOLLY BETH DOUCETTE ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 74 KING ST HEALTH SERVICES
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-4342
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Country | US
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Telephone | 904-819-6211
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Fax | 904-824-1183
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Provider Business Mailing Address
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Address Line | PO BOX 1027
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32085-1027
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Country | US
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Telephone | 904-819-6211
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Fax | 904-824-1183
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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 | ARNP 1637582
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License Number State | FL
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