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General NPI Number Information
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NPI Number | 1346973088
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Entity Type | Individual
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Provider Name | EMILY ANNE ARCHER APRN
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Gender | Female
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 858 MONUMENT RD STE B
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City | JACKSONVILLE
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State | FL
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Zip | 32225-6670
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Country | US
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Telephone | 904-450-8090
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Fax |
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Provider Business Mailing Address
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Address Line | 4205 BELFORT RD STE 4015
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City | JACKSONVILLE
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State | FL
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Zip | 32216-3623
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Country | US
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Telephone | 904-450-8090
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11020671
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APRN11020671
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License Number State | FL
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