MEDICARE: LAUREN J MARCHEFKA FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95000148	CA

General Provider Information

NPI Number	:	1538590021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN J MARCHEFKA FNP

Provider Business Mailing Address
First Line	:	4210 VALLEY RIDGE BLVD STE 101
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32081-5171
Country	:	US
Telephone Number	:	904-593-8480
Fax Number	:	904-593-8480

Provider Business Practice Location Address
First Line	:	4210 VALLEY RIDGE BLVD STE 101
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32081-5171
Country	:	US
Telephone Number	:	904-593-8480
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2013
Last Update Date	:	12/15/2025

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