Provider Demographics
NPI:1194520924
Name:MARCELIN, JOSEPHINE (NP)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:MARCELIN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10342 WOODLEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-9186
Mailing Address - Country:US
Mailing Address - Phone:904-535-2100
Mailing Address - Fax:
Practice Address - Street 1:6820 SAINT AUGUSTINE RD STE A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2818
Practice Address - Country:US
Practice Address - Phone:904-337-1268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11035143363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily