MEDICARE: DANA YVONNE PRESTON PHD, APRN, - C.S

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	APRN1145002	FL
2	363L00000X	Nurse Practitioner	APRN1145002	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1861699225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA YVONNE PRESTON PHD, APRN, - C.S

Provider Business Mailing Address
First Line	:	PO BOX 746638
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6638
Country	:	US
Telephone Number	:	904-202-1032
Fax Number	:	904-376-4107

Provider Business Practice Location Address
First Line	:	5491 DOLPHIN POINT BLVD STE 3110
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-3221
Country	:	US
Telephone Number	:	904-744-5244
Fax Number	:	904-390-7474

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

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	09/26/2023

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