GERISOURCE NPI 1871894972

NPI Information

NPI: 1871894972
Provider Name: GERISOURCE
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Organization

Specialization: Gerontology

Address:
11812 CRUSSELLE DR
JACKSONVILLE, FL
ZIP 32223
Phone: (904) 252-5265
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GERISOURCE is a gerontology nurse practitioner in Jacksonville, FL. GERISOURCE NPI is 1871894972. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11812 CRUSSELLE DR
JACKSONVILLE, FL
ZIP 32223-876
Phone: (904) 252-5265

The provider's authorized official is Andrea H Clayman .
The authorized official title is President and has the following contact phone number (904) 252-5265.

The enumeration date for this NPI number is 11/6/2010 and was last updated on 11/6/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	9260038	FLORIDA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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