Sutherland, Mary Josephine
Sutherland, Mary Josephine is an individual health care provider with primary practice located at 3189 Us Highway 17 , Fleming Island FL 32003-7109. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Sutherland, Mary Josephine can be contacted via phone (904) 621-0247.Contact Information
Primary practice address
3189 Us Highway 17
Fleming Island FL 32003-7109
Phone: (904) 621-0247
Fax: (904) 339-9945
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA2225 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA2225 | Florida |
Profile Details
| NPI number | 1912927237 |
|---|---|
| LBN Legal business name | Sutherland, Mary Josephine |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2006 |
| Last updated | Sep 21st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912927237 | NPPES |
| Florida | MEDICAID | 291115900 |
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