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General NPI Number Information
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NPI Number | 1417124892
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Entity Type | Individual
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Provider Name | MRS. KATRINA LEFAYE JAMES
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Gender | Female
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 3504 NORTH DAVIS STREET
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City | JACKSONVILLE
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State | FL
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Zip | 32209-4456
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Country | US
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Telephone | 904-632-2019
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Fax | 904-632-2019
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Provider Business Mailing Address
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Address Line | 3504 NORTH DAVIS STREET
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City | JACKSONVILLE
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State | FL
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Zip | 32209-4456
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Country | US
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Telephone | 904-632-2019
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Fax | 904-632-2019
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 69042596
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number | 08IV028
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License Number State | FL
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