Provider Demographics
NPI:1477901866
Name:O'STEEN, LACINDA LOU (ARNP FNP)
Entity Type:Individual
Prefix:
First Name:LACINDA
Middle Name:LOU
Last Name:O'STEEN
Suffix:
Gender:F
Credentials:ARNP FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 N SEA LAKE LN
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-4756
Mailing Address - Country:US
Mailing Address - Phone:386-965-7066
Mailing Address - Fax:
Practice Address - Street 1:12795 SAN JOSE BLVD STE 9
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8676
Practice Address - Country:US
Practice Address - Phone:904-265-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2159272163WA2000X, 163WC0400X, 163WC1600X, 163WD0400X, 163WH0200X, 163WI0600X, 163WM0705X, 163WP0808X, 3104A0630X
NCRN2159272163WH1000X
FL174H00000X
MARN2313010363LF0000X
FLA4M363LW0102X
FLARNP2159272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No174H00000XOther Service ProvidersHealth Educator
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01801192OtherRR MEDICARE
FLP01801192OtherRR MEDICARE