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General NPI Number Information
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NPI Number | 1558036269
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Entity Type | Individual
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Provider Name | ABBY REGINA USSELMANN APRN
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Gender | Female
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 6930 BONNEVAL RD STE 2
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6084
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Country | US
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Telephone | 904-854-6899
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Fax | 904-376-3210
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Provider Business Mailing Address
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Address Line | PO BOX 746652
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City | ATLANTA
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State | GA
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Zip | 30374-6652
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Country | US
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Telephone | 904-720-0599
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Fax | 904-376-4036
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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 | 11062-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11032717
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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 | APRN11032717
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License Number State | FL
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