MEDICARE: STANDREA L TELFAIR CNA

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	253Z00000X	In Home Supportive Care Agency	239733	FL
2	372600000X	Adult Companion	239733	FL

General Provider Information

NPI Number	:	1942168836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANDREA L TELFAIR CNA

Provider Business Mailing Address
First Line	:	653 MONUMENT RD APT 609
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-6468
Country	:	US
Telephone Number	:	904-442-4521
Fax Number	:	904-442-4521

Provider Business Practice Location Address
First Line	:	653 MONUMENT RD APT 609
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-6468
Country	:	US
Telephone Number	:	904-442-4521
Fax Number	:	904-442-4521

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ STANDREA L TELFAIR CNA” Practice Location

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