Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Lisa Dawn Booth, FNP

Individual provider Family Nurse Practitioner · NPI 1306248182

MS. Lisa Dawn Booth, FNP is a Nurse Practitioner in Jacksonville, Florida. Qualified in 2014, 12 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
12
Licensed in
TN
In the registry since
2014
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

3614 Blanding Blvd
Jacksonville, FL 32210-5241
Phone: (904) 419-7100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 145 Innovation Dr, Jackson, TN 38305-3019 — (731) 422-0213

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 19109 (TN)

Record details

NPI number1306248182
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedSeptember 23, 2014
Last updated in NPPESJuly 28, 2026
Certification dateJuly 28, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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