Individual
AJLA HUREM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4844 DEER LAKE DR W STE 101, JACKSONVILLE, FL 32246-4406
(904) 376-3800
Mailing address
PO BOX 748519, ATLANTA, GA 30374-8519
(904) 376-3800
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11007626
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115349200
—
FL
Enumeration date
06/17/2020
Last updated
12/12/2023
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