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NPI 1679613343

NPI 1679613343 : ALEXANDERIA OCTAVIA BURWELL ARNP-BC : JACKSONVILLE, FL

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General NPI Number Information
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    NPI Number           |    1679613343
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXANDERIA OCTAVIA BURWELL ARNP-BC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/08/2007
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    Last Update Date     |    02/03/2015
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Provider Practice Location Address
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    Address Line         |    1605 N MYRTLE AVE UFJAX - UF HEALTH WELLNESS & EDUCATION CENTER
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32209-9618
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    Country              |    US
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    Telephone            |    904-350-1197
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    Fax                  |    904-350-9651
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Provider Business Mailing Address
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    Address Line         |    PO BOX 44008 UFJAX - PROVIDER ENROLLMENT
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32231-4008
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    Country              |    US
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    Telephone            |    904-244-3199
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    Fax                  |    904-244-3425
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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       |    ARNP2901152
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    License Number State |    FL
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