Provider Demographics
NPI:1245617083
Name:MOFFEIT, KRISTIN (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:MOFFEIT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6063
Mailing Address - Fax:904-539-4091
Practice Address - Street 1:7720 US HIGHWAY 98 W STE 310
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-7232
Practice Address - Country:US
Practice Address - Phone:850-267-2961
Practice Address - Fax:850-278-3780
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9448818363LW0102X
NVAPRN001917363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health