Provider Demographics
NPI:1982356853
Name:JOSEPH-EXINORD, DENISE M (ARNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:JOSEPH-EXINORD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 OLD KINGS RD S
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-9116
Mailing Address - Country:US
Mailing Address - Phone:386-445-1405
Mailing Address - Fax:386-445-2814
Practice Address - Street 1:1 OLD KINGS RD S
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-9116
Practice Address - Country:US
Practice Address - Phone:386-445-1405
Practice Address - Fax:386-445-2814
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11017142363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMJ7190402Medicaid