Provider Demographics
NPI:1184354011
Name:LOUIS, ANDJIE CASSANDRE (APRN)
Entity type:Individual
Prefix:MRS
First Name:ANDJIE
Middle Name:CASSANDRE
Last Name:LOUIS
Suffix:
Gender:
Credentials:APRN
Other - Prefix:MRS
Other - First Name:ANDJIE
Other - Middle Name:CASSANDRE
Other - Last Name:FENELON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9504 CROSSHILL BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-5851
Mailing Address - Country:US
Mailing Address - Phone:904-308-7792
Mailing Address - Fax:
Practice Address - Street 1:2080 CHILD ST DEPT 5000
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-5851
Practice Address - Country:US
Practice Address - Phone:904-542-4677
Practice Address - Fax:904-542-7394
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020163363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner