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NPI Code Detail

MEDICARE: DANA PICKENS MSN, ARNP, FNP-C

MEDICARE: DANA PICKENS MSN, ARNP, FNP-C
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 Practitioner9463164FL

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 : 1760998991
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA PICKENS MSN, ARNP, FNP-C
Provider Business Mailing Address
First Line : 7406 FULLERTON ST STE 105
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-3588
Country : US
Telephone Number : 877-868-4827
Fax Number :
Provider Business Practice Location Address
First Line : 7406 FULLERTON ST STE 105
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-3588
Country : US
Telephone Number : 877-868-4827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2017
Last Update Date : 03/30/2021

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