Organization
GERISOURCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA H CLAYMAN ARNP (PRESIDENT)
(904) 252-5265
Entity
Organization
Contact information
Practice address
11812 CRUSSELLE DR, JACKSONVILLE, FL 32223-0876
(904) 252-5265
Mailing address
11812 CRUSSELLE DR, JACKSONVILLE, FL 32223-0876
(904) 252-5265
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
9260038
FL
Other
Enumeration date
11/06/2010
Last updated
11/06/2010
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