MEDICARE: JANEY NICOLE SAPPE

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	APRN813242	FL

General Provider Information

NPI Number	:	1225592561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANEY NICOLE SAPPE

Provider Business Mailing Address
First Line	:	5851 TIMUQUANA RD STE 401
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-8100
Country	:	US
Telephone Number	:	904-317-5069
Fax Number	:	904-778-6440

Provider Business Practice Location Address
First Line	:	5851 TIMUQUANA RD STE 401
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-8100
Country	:	US
Telephone Number	:	904-317-5069
Fax Number	:	904-778-6440

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

Provider Enumeration Date	:	01/30/2019
Last Update Date	:	01/30/2019

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