Provider Demographics
NPI:1013287762
Name:ADAMS, FAITH ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:ANN
Other - Last Name:MARCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:GATEWAY WELLNESS
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-3199
Mailing Address - Fax:904-244-3425
Practice Address - Street 1:5200 NORWOOD AVE
Practice Address - Street 2:STE 18
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-5029
Practice Address - Country:US
Practice Address - Phone:904-244-0872
Practice Address - Fax:904-764-5197
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9186600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004519200Medicaid
FLFU859ZMedicare PIN