Provider Demographics
NPI:1639746902
Name:THURMAN, KALI ASHLYN (MSN, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:ASHLYN
Last Name:THURMAN
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4609 HARTMAN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-1323
Mailing Address - Country:US
Mailing Address - Phone:904-386-8392
Mailing Address - Fax:
Practice Address - Street 1:4609 HARTMAN RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-1323
Practice Address - Country:US
Practice Address - Phone:904-386-8392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9385223163W00000X
FL11013583363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse