Provider Demographics
NPI:1194362384
Name:SAPP, ABBY (APRN)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:SAPP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:BERTHOLF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2121 PARK ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-3811
Mailing Address - Country:US
Mailing Address - Phone:904-387-6200
Mailing Address - Fax:
Practice Address - Street 1:2121 PARK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-3811
Practice Address - Country:US
Practice Address - Phone:904-387-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002782363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics