MEDICARE: JUDITH G REWIS 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	ARNP3266942	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	:	1962653212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH G REWIS ARNP

Provider Business Mailing Address
First Line	:	PO BOX 43667
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32203-3667
Country	:	US
Telephone Number	:	904-720-0599
Fax Number	:	904-376-4036

Provider Business Practice Location Address
First Line	:	1747 BAPTIST CLAY DR STE 320
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-8503
Country	:	US
Telephone Number	:	904-224-5185
Fax Number	:	904-278-7284

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

Provider Enumeration Date	:	10/06/2008
Last Update Date	:	05/16/2023

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Directions to “ JUDITH G REWIS ARNP” Practice Location

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