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General NPI Number Information
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NPI Number | 1154182020
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Entity Type | Organization
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Legal Business Name | A NEW WAY HEALTHCARE, LLC
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 2380 3RD ST S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4072
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Country | US
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Telephone | 904-299-0373
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Fax | 844-270-6871
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Provider Business Mailing Address
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Address Line | 2380 3RD ST S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4072
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Country | US
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Telephone | 904-299-0373
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Fax | 844-270-6871
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Authorized Official
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Title or Position | OWNER
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Name | ANA LINARES STAUCH
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Credential | APRN
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Telephone | 904-563-3380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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