Waters, Michelle Nichole

Waters, Michelle Nichole is an individual health care provider with primary practice located at 2377 Dunn Ave , Jacksonville FL 32218-6983. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Waters, Michelle Nichole can be contacted via phone (904) 633-0700.

Contact Information

Primary practice address
2377 Dunn Ave Jacksonville FL 32218-6983
Phone: (904) 633-0700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9337907 Florida
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X ARNP9337907 Florida

Profile Details

NPI number 1376091165
LBN Legal business name Waters, Michelle Nichole
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2016
Last updated Apr 17th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376091165 NPPES
Florida MEDICAID 019282800

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