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General NPI Number Information
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NPI Number | 1033412549
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Entity Type | Individual
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Provider Name | THERESA ANNE NARASIMHAN RN, MSN
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Gender | Female
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 1431 RIVERPLACE BLVD UNIT 3408
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City | JACKSONVILLE
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State | FL
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Zip | 32207-9028
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Country | US
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Telephone | 414-336-4399
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 RIVERPLACE BLVD UNIT 3408
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City | JACKSONVILLE
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State | FL
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Zip | 32207-9028
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Country | US
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Telephone | 414-336-4399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209.008804
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 9360704
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F306932-1
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License Number State | NY
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