Individual provider Active NPI

Brittany Elizabeth Gaspar Nettles, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1164047957
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11007441 Issued in FL
Practice address
1604 Kilchurn Rd
Jacksonville, FL 32221-3871
Phone
(352) 283-5690
NPI assigned
Jun 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11007441 FL Primary

Addresses

Primary practice location

1604 Kilchurn Rd
Jacksonville, FL 32221-3871

Mailing address

1604 Kilchurn Rd
Jacksonville, FL 32221-3871
Phone (352) 283-5690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APRN11007441FLMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1164047957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 KILCHURN RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322213871",
            "telephone_number": "352-283-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 KILCHURN RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322213871",
            "telephone_number": "352-283-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTLES",
        "first_name": "BRITTANY",
        "middle_name": "ELIZABETH GASPAR",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11007441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.