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General NPI Number Information
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NPI Number | 1639655897
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Entity Type | Individual
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Provider Name | MEGAN ANNE WOLLITZ APRN
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Gender | Female
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 05/06/2019
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Provider Practice Location Address
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Address Line | 1 UNF DRIVE
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City | JACKSONVILLE
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State | FL
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Zip | 32224
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Country | US
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Telephone | 904-202-1595
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Fax |
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Provider Business Mailing Address
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Address Line | 655 10TH AVE S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-5141
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Country | US
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Telephone | 321-890-2086
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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 | 9318409
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License Number State | FL
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