Healthcare Provider Details

I. General information

NPI: 1982063244
Provider Name (Legal Business Name): SUZANNE J LEFFEW MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7603 LEM TURNER RD
JACKSONVILLE FL
32208-3252
US

IV. Provider business mailing address

PO BOX 550789
JACKSONVILLE FL
32255-0789
US

V. Phone/Fax

Practice location:
  • Phone: 904-329-3336
  • Fax: 904-517-8919
Mailing address:
  • Phone: 904-329-3336
  • Fax: 904-517-8919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9257764
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: