Healthcare Provider Details

I. General information

NPI: 1912853581
Provider Name (Legal Business Name): MRS. ASHLEY ELIZABETH SPEARS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6428 BEACH BLVD
JACKSONVILLE FL
32216-2813
US

IV. Provider business mailing address

29 NAOMI CT
MILTON WV
25541-1282
US

V. Phone/Fax

Practice location:
  • Phone: 904-475-2039
  • Fax: 904-330-0668
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11047333
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number125459
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: