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NPI Code Detail

MEDICARE: MRS. JULIETTE A SPENCE SEGREE APRN

MEDICARE: MRS. JULIETTE A SPENCE SEGREE APRN
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
1363LF0000XFamily Nurse PractitionerAPRN2001712FL
2363LX0001XObstetrics & Gynecology Nurse PractitionerAPRN2001712FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588967673
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIETTE A SPENCE SEGREE APRN
Provider Business Mailing Address
First Line : 1324 LAKELAND HILLS BLVD
Second Line : MANAGED CARE DEPT
City : LAKELAND
State : FL
Zip : 33805-3203
Country : US
Telephone Number : 863-687-1100
Fax Number :
Provider Business Practice Location Address
First Line : 1525 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-3203
Country : US
Telephone Number : 863-577-2140
Fax Number : 863-413-8518
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2010
Last Update Date : 08/04/2022

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