Basic Information
| Provider Information | |||||||||
| NPI: | 1679734172 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOHR | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | DIANNE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 836 PRUDENTIAL DRIVE | ||||||||
| Address2: | SUITE 1800 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043987684 | ||||||||
| FaxNumber: | 9043984998 | ||||||||
| Practice Location | |||||||||
| Address1: | 836 PRUDENTIAL DRIVE | ||||||||
| Address2: | SUITE 1800 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043987684 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2008 | ||||||||
| LastUpdateDate: | 11/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP1700X | ARNP9172603 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Perinatal | 363LF0000X | ARNP9172603 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.