MEDICARE: DEBBIE GLORIA 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
1	363LA2200X	Adult Health Nurse Practitioner	ARNP9204692	FL

General Provider Information

NPI Number	:	1902819931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBIE GLORIA ARNP

Provider Business Mailing Address
First Line	:	4727 SUNBEAM RD
Second Line	:	SUITE 101
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-6187
Country	:	US
Telephone Number	:	904-880-0622
Fax Number	:	904-880-0623

Provider Business Practice Location Address
First Line	:	1545 S 14TH ST
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-3049
Country	:	US
Telephone Number	:	904-261-7500
Fax Number	:	904-261-2166

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	09/08/2020

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