Healthcare Provider Details

I. General information

NPI: 1871543520
Provider Name (Legal Business Name): JANELL L VERKADEN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 CLYDE MORRIS BLVD STE 450
ORMOND BEACH FL
32174-8179
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 386-673-2442
  • Fax: 386-673-4884
Mailing address:
  • Phone: 239-274-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 14I79242
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN1479242
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code364SX0200X
TaxonomyOncology Clinical Nurse Specialist
License Number364SX0200X
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: