Provider Demographics
NPI:1881958783
Name:DOUCETTE, HOLLY BETH (ARNP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:BETH
Last Name:DOUCETTE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1027
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32085-1027
Mailing Address - Country:US
Mailing Address - Phone:904-819-6211
Mailing Address - Fax:904-824-1183
Practice Address - Street 1:74 KING ST
Practice Address - Street 2:HEALTH SERVICES
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-4342
Practice Address - Country:US
Practice Address - Phone:904-819-6211
Practice Address - Fax:904-824-1183
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1637582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily