MEDICARE: MS. YULANDA T FAISON- OYEBANJI DNP, NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	AP05328	LA
2	363L00000X	Nurse Practitioner	3777	SC
3	363L00000X	Nurse Practitioner	ARNP9265595	FL
4	363LF0000X	Family Nurse Practitioner	RN153816	GA
5	363LF0000X	Family Nurse Practitioner	265850	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174707236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. YULANDA T FAISON- OYEBANJI DNP, NP

Provider Business Mailing Address
First Line	:	463688 STATE ROAD 200
Second Line	:
City	:	YULEE
State	:	FL
Zip	:	32097-0304
Country	:	US
Telephone Number	:	904-608-2900
Fax Number	:

Provider Business Practice Location Address
First Line	:	4320 DEERWOOD LAKE PKWY
Second Line	:	310
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-1177
Country	:	US
Telephone Number	:	904-608-2900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2007
Last Update Date	:	03/15/2018

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