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Angela Hartman Perrin

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4500 San Pablo Road, Davis 7b-East, Jacksonville, FL 32224

(904) 953-2000

PECOS Enrollment

This provider is enrolled in PECOS as ANGELA PERRIN.

Based on the most recent information from CMS, provider Angela Hartman Perrin is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 8 days ago.

Profile Details

Provider ID
1538120266
Provider Type
Individual
Full Name
Perrin, Angela Hartman
Title
Mrs.
Credential
ARNP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
3/31/2006
Last Updated
5/20/2009

Contact Information

Practice Location

4500 San Pablo Road, Davis 7b-East, Jacksonville, FL 32224

(904) 953-2000

(904) 953-2911

Mailing Location

4500 San Pablo Road, Division Of Cardiology , Davis 7b East, Jacksonville, FL 32224

(904) 953-2000

(904) 953-2911

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License ARNP9180585 Florida

Provider Identifiers

ID	Description	Issuer
ID 3072975-00	Description Medicaid	Issuer Unlisted Florida

Angela Hartman Perrin

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Rogers, Emily Rose

Cushenbery, Kristin

Mazer, Laura S

Fuller, Kimberly J

Barber, Melinda

Ayer, Faith Elizabeth

Nobles, Daniel

Arthurs, Jennifer

Dehr, Lindsay Mychael

Watson, Cecilia