Healthcare Provider Details
I. General information
NPI: 1457334906
Provider Name (Legal Business Name): AMY B TOENJES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/29/2005
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14546 OLD SAINT AUGUSTINE RD SUITE 301
JACKSONVILLE FL
32258-5468
US
IV. Provider business mailing address
14546 OLD SAINT AUGUSTINE RD SUITE 301
JACKSONVILLE FL
32258-5468
US
V. Phone/Fax
- Phone: 904-292-4049
- Fax: 904-292-4805
- Phone: 904-292-4049
- Fax: 904-292-4805
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SN0800X |
| Taxonomy | Neuroscience Clinical Nurse Specialist |
| License Number | ARNP 9252123 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: