CROSSROADS HEALTH & WELLNESS CENTER NPI 1407520554

NPI Information

NPI: 1407520554
Provider Name: CROSSROADS HEALTH & WELLNESS CENTER

Doing Business As: CROSSROADS HEALTH AND WELLNESS

Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 10D2031844

Address:
5960 BEACH BLVD STE 3
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 358-1211
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CROSSROADS HEALTH & WELLNESS CENTER is a primary care nurse practitioner in Jacksonville, FL. CROSSROADS HEALTH & WELLNESS CENTER NPI is 1407520554. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Crossroads Health And Wellness.

The provider's business location address is:

5960 BEACH BLVD STE 3
JACKSONVILLE, FL
ZIP 32207-113
Phone: (904) 358-1211

The provider's authorized official is Marianna Dowell .
The authorized official title is Assessment Counselor and has the following contact phone number (904) 701-0229.

The CLIA number assigned to this NPI record is 10D2031844 - other - community faith based org with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/3/2021 and was last updated on 8/5/2022.

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	Primary
1	207Q00000X	Family Medicine		No
2	2084P0800X	Psychiatry & Neurology	Psychiatry	No
3	251S00000X	Community/Behavioral Health		No
4	261QH0100X	Clinic/Center	Health Service	No
5	363LP2300X	Nurse Practitioner	Primary Care	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: 5/5/2024

NPI Synchronization or Removal

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