Provider Demographics
NPI:1821853888
Name:MONBERG, KARLEY (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KARLEY
Middle Name:
Last Name:MONBERG
Suffix:
Gender:F
Credentials:APRN, FNP-C
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 1103
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8338
Mailing Address - Country:US
Mailing Address - Phone:386-451-6242
Mailing Address - Fax:
Practice Address - Street 1:836 PRUDENTIAL DR STE 1103
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8338
Practice Address - Country:US
Practice Address - Phone:904-398-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9452526363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily