Healthcare Provider Details

I. General information

NPI: 1407129117
Provider Name (Legal Business Name): ASHLEY A SPENCER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY A FLOOD CRNA

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 BELFORT RD
JACKSONVILLE FL
32256-6004
US

IV. Provider business mailing address

86648 RIVERWOOD DR
YULEE FL
32097-6446
US

V. Phone/Fax

Practice location:
  • Phone: 904-483-5850
  • Fax: 904-265-6409
Mailing address:
  • Phone: 904-563-4228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9262984
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN231039
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberAPRN9262984
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: