Healthcare Provider Details

I. General information

NPI: 1144114828
Provider Name (Legal Business Name): WILLIAM EDWARD SEWELL APRN, FNP-BC, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3948 3RD ST S # 165
JACKSONVILLE FL
32250-5847
US

IV. Provider business mailing address

3948 3RD ST S # 165
JACKSONVILLE FL
32250-5847
US

V. Phone/Fax

Practice location:
  • Phone: 904-684-4795
  • Fax: 904-895-6227
Mailing address:
  • Phone: 904-684-4795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11039931
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: