MEDICARE: MS. ESTELLE JANE DAVIS HODNETT NP, ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	783732	FL

General Provider Information

NPI Number	:	1093043937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ESTELLE JANE DAVIS HODNETT NP, ARNP

Provider Business Mailing Address
First Line	:	401 BAY POINT WAY NORTH
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32259-7907
Country	:	US
Telephone Number	:	904-687-3677
Fax Number	:	904-230-6969

Provider Business Practice Location Address
First Line	:	4051 PHILIPS HIGHWAY
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-7299
Country	:	US
Telephone Number	:	904-737-5220
Fax Number	:	904-448-6794

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2009
Last Update Date	:	12/04/2009

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