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NPI Code Detail

MEDICARE: JAU EVANS APRN

MEDICARE: JAU EVANS APRN
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
1363LF0000XFamily Nurse PractitionerARNP9310152FL

Other Identifiers

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

General Provider Information

NPI Number : 1497269880
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAU EVANS APRN
Provider Business Mailing Address
First Line : DEPT. #394
Second Line : P.O. BOX 1000
City : MEMPHIS
State : TN
Zip : 38148-0001
Country : US
Telephone Number : 941-300-4440
Fax Number : 941-404-1760
Provider Business Practice Location Address
First Line : 4615 PHILIPS HWY STE 3
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-9541
Country : US
Telephone Number : 904-760-4904
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2017
Last Update Date : 01/30/2024

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Directions to “ JAU EVANS APRN” Practice Location

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