Provider Demographics
NPI:1689994865
Name:SARGENT, CAITLIN GRACE (ARNP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:GRACE
Last Name:SARGENT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:GRACE
Other - Last Name:MCCALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 N LEE ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-1128
Mailing Address - Country:US
Mailing Address - Phone:904-354-8200
Mailing Address - Fax:904-354-1340
Practice Address - Street 1:425 N LEE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-1128
Practice Address - Country:US
Practice Address - Phone:904-354-8200
Practice Address - Fax:904-354-1340
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9246620363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner