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NPI Code Detail

MEDICARE: MS. SANDRA JEAN CROSSEN ARNP

MEDICARE: MS. SANDRA JEAN CROSSEN ARNP
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 PractitionerARNP1521042FL

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 : 1669804290
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SANDRA JEAN CROSSEN ARNP
Provider Business Mailing Address
First Line : 4266 SUNBEAM RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-2425
Country : US
Telephone Number : 904-407-6198
Fax Number : 904-407-6098
Provider Business Practice Location Address
First Line : 4266 SUNBEAM RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-2425
Country : US
Telephone Number : 904-407-6198
Fax Number : 904-407-6098
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2013
Last Update Date : 08/06/2013

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