Provider Demographics
NPI:1861711996
Name:AUGUSTINE, BRANDY MARIA (ARNP)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:MARIA
Last Name:AUGUSTINE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 PRUDENTIAL DR STE 1400
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8340
Mailing Address - Country:US
Mailing Address - Phone:904-348-0974
Mailing Address - Fax:904-348-5627
Practice Address - Street 1:836 PRUDENTIAL DR STE 1400
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8340
Practice Address - Country:US
Practice Address - Phone:904-348-0974
Practice Address - Fax:904-348-5627
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9204358363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner