Individual provider Active NPI

Kathleen Anne Nolan, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1407707201
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11031274 Issued in FL
Practice address
1697 Kings Rd Ste 1
Jacksonville, FL 32209-6169
Phone
(904) 478-5483
NPI assigned
Feb 6, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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 APRN11031274 FL Primary

Addresses

Primary practice location

1697 Kings Rd Ste 1
Jacksonville, FL 32209-6169

Mailing address

153 Ferrol Rd
St Augustine, FL 32084-2966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1697 Kings Rd
Suite 1
Jacksonville, FL 32209-6169

2755 Amman St
Pittsburgh, PA 15226-1732

PO Box
Suite 43418
Jacksonville, FL 32203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11031274FLMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1770336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1407707201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 FERROL RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1697 KINGS RD STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096169",
            "telephone_number": "904-478-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-06",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11031274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.