MEDICARE: MS. TANYA FELICIA ADAMS FNP

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	3023072	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	:	1972085876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TANYA FELICIA ADAMS FNP

Provider Business Mailing Address
First Line	:	2657 MYRA ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-3517
Country	:	US
Telephone Number	:	904-377-3769
Fax Number	:

Provider Business Practice Location Address
First Line	:	2657 MYRA ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-3517
Country	:	US
Telephone Number	:	904-377-3769
Fax Number	:

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

Provider Enumeration Date	:	09/06/2018
Last Update Date	:	02/18/2025

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