Healthcare Provider Details

I. General information

NPI: 1902819931
Provider Name (Legal Business Name): DEBBIE GLORIA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBBIE R. GLORIA ARNP

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/08/2020
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 S 14TH ST
FERNANDINA BEACH FL
32034-3049
US

IV. Provider business mailing address

4727 SUNBEAM RD SUITE 101
JACKSONVILLE FL
32257-6187
US

V. Phone/Fax

Practice location:
  • Phone: 904-261-7500
  • Fax: 904-261-2166
Mailing address:
  • Phone: 904-880-0622
  • Fax: 904-880-0623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9204692
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: