Provider Demographics
NPI:1942563200
Name:BRAGG, KARA J (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:J
Last Name:BRAGG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:KARA
Other - Middle Name:J
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4500 SAN PABLO RD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-1865
Mailing Address - Country:US
Mailing Address - Phone:904-953-2000
Mailing Address - Fax:
Practice Address - Street 1:4311 SALISBURY RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6123
Practice Address - Country:US
Practice Address - Phone:904-332-4316
Practice Address - Fax:904-332-4339
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3018222363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty