Healthcare Provider Details

I. General information

NPI: 1245587393
Provider Name (Legal Business Name): CASEY EDWARDS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASEY LEANN TODD ARNP

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 WELLS RD STE 3
ORANGE PARK FL
32073-2303
US

IV. Provider business mailing address

1635 WELLS RD STE 3
ORANGE PARK FL
32073-2303
US

V. Phone/Fax

Practice location:
  • Phone: 904-300-5949
  • Fax: 904-592-5886
Mailing address:
  • Phone: 904-300-5949
  • Fax: 904-592-5886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP3394102
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: