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General NPI Number Information
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NPI Number | 1699438812
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Entity Type | Individual
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Provider Name | MECHELLE CASWELL-HERRERA FNP-BC, NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 1100 CESERY BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32211-5674
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Country | US
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Telephone | 904-551-5884
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Fax | 904-562-3384
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Provider Business Mailing Address
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Address Line | 12250 SPINEY RIDGE DR S
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City | JACKSONVILLE
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State | FL
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Zip | 32225-1623
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Country | US
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Telephone | 423-741-2980
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11015908
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License Number State | FL
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