Healthcare Provider Details

I. General information

NPI: 1801138391
Provider Name (Legal Business Name): DENISE MARIE WARD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENISE MARIE SAYLES

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 11/25/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 DUNN AVE SUITE1
JACKSONVILLE FL
32218-6330
US

IV. Provider business mailing address

6520 FORT CAROLINE RD
JACKSONVILLE FL
32277-2044
US

V. Phone/Fax

Practice location:
  • Phone: 904-696-7474
  • Fax: 904-696-7476
Mailing address:
  • Phone: 904-745-3618
  • Fax: 904-722-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0313137
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN2124872
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN2124872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: