Healthcare Provider Details

I. General information

NPI: 1821579103
Provider Name (Legal Business Name): TIFFANY N MAJOR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 PARK AVE
ORANGE PARK FL
32073-4152
US

IV. Provider business mailing address

101 CENTURY 21 DR STE 202
JACKSONVILLE FL
32216-9293
US

V. Phone/Fax

Practice location:
  • Phone: 904-269-2437
  • Fax: 904-264-2330
Mailing address:
  • Phone: 904-289-1440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9352616
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: