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NPI Code Detail

MEDICARE: MRS. EMMA E ATWELL PA-C

MEDICARE: MRS. EMMA E ATWELL PA-C
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
1363A00000XPhysician AssistantPA9112134FL

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 : 1821640624
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMMA E ATWELL PA-C
Provider Business Mailing Address
First Line : 3627 UNIVERSITY BLVD S STE 500
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-7405
Country : US
Telephone Number : 904-399-5678
Fax Number : 904-399-8488
Provider Business Practice Location Address
First Line : 3627 UNIVERSITY BLVD S STE 500
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-7405
Country : US
Telephone Number : 904-399-5678
Fax Number : 904-399-8488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2019
Last Update Date : 04/01/2021

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Directions to “ MRS. EMMA E ATWELL PA-C” Practice Location

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