Provider Demographics
NPI:1699524322
Name:AMEEN, LOURICE A (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:LOURICE
Middle Name:A
Last Name:AMEEN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11196 CASTLEMAIN CIR W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4828
Mailing Address - Country:US
Mailing Address - Phone:904-891-3242
Mailing Address - Fax:
Practice Address - Street 1:11196 CASTLEMAIN CIR W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-4828
Practice Address - Country:US
Practice Address - Phone:904-891-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11032112207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine