LACY DANIELLE GULLEDGE (NPI# 1609387174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609387174 |
| Entity Type | Individual |
| Full Name | LACY DANIELLE GULLEDGE |
| Other Name | LACY WADE |
| Credential | ARNP |
| Practice Address |
15255 Max Leggett Pkwy Jacksonville FL 32218-7273 |
| Mailing Address |
75338 Ravenwood Dr Yulee FL 32097-1609 |
| Practice Telephone | 9042440411 |
| Mailing Telephone | 3342086190 |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2018-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
ARNP9429348 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
ARNP9429348 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15255 MAX LEGGETT PKWY |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-7273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194727677 | George Michael Hagy | Pharmacist | 15255 Max Leggett Pkwy, Jacksonville, FL 32218 | 2005-08-13 |
| 1417558982 | Alexia King | Registered Nurse | 15255 Max Leggett Pkwy, Jacksonville, FL 32218-7273 | 2020-11-02 |
| 1013524685 | Trevena Nicole Sanders | Nurse Practitioner | 15255 Max Leggett Pkwy, Jacksonville, FL 32218-7273 | 2020-09-28 |
| 1801447685 | Genelyn M Baroso | Pharmacist | 15255 Max Leggett Pkwy, Jacksonville, FL 32218-7273 | 2019-09-24 |
| 1235789546 | Paige Alyssa Bishop | Pharmacist | 15255 Max Leggett Pkwy, Jacksonville, FL 32218-7273 | 2019-09-18 |
| 1841778461 | Hospitalist Medicine Physicians of Florida - Jacksonville, LLC | Internal Medicine | 15255 Max Leggett Pkwy, Jacksonville, FL 32218-7273 | 2018-08-06 |
| 1013419282 | Transcendent Multiservice Assist, LLC | Registered Nurse | 15255 Max Leggett Pkwy, Jacksonville, FL 32218-7273 | 2018-03-05 |
| 1407360894 | Brittany Yonker Allsup | Nurse Practitioner | 15255 Max Leggett Pkwy, Jacksonville, FL 32218-7273 | 2017-11-22 |
| 1578008132 | Oanh Yvonne Green | Nurse Anesthetist, Certified Registered | 15255 Max Leggett Pkwy, Jacksonville, FL 32218-7273 | 2017-01-05 |
| 1548711773 | Brandon Centeno | Specialist/Technologist | 15255 Max Leggett Pkwy, Suite 6600, Jacksonville, FL 32218-7273 | 2016-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265081517 | Patsy Taylor | Nurse Practitioner | 8518 Julia Marie Cir, Jacksonville, FL 32210-0412 | 2019-09-10 |
| 1801449624 | Jamie Lea Laakmann | Nurse Practitioner | 14890 Bartram Creek Blvd, Jacksonville, FL 32259-7044 | 2019-07-21 |
| 1003312539 | Michael Eric Bristow | Nurse Practitioner | 11481 Old Saint Augustine Rd Ste 303, Jacksonville, FL 32258-1476 | 2018-04-03 |
| 1982159190 | Dena Alexander | Nurse Practitioner | 12015 Stacy Scott Ct, Jacksonville, FL 32223-0780 | 2016-08-17 |
| 1871820159 | Kay Frances Fullwood | Nurse Practitioner | 2345 Luana Dr E, Jacksonville, FL 32246-9561 | 2009-11-08 |
| 1023048147 | Laura J Rowe | Nurse Practitioner | 3599 University Blvd. South, Jacksonville, FL 32216 | 2006-07-04 |
| 1871581660 | Lolita Condino Massengill | Nurse Practitioner | 6665 Banbury Road, Jacksonville, FL 32211 | 2005-10-06 |
| 1114926037 | Andrea H Clayman | Nurse Practitioner | 11812 Crusselle Dr, Jacksonville, FL 32223-0876 | 2005-07-21 |
| 1467088724 | Mary Joy Castro Whitmire | Nurse Practitioner | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-03-19 |
| 1386120087 | Heidi Diane Brown | Nurse Practitioner | 915 W Monroe St Ste 200, Jacksonville, FL 32204-1177 | 2018-07-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
Please comment or provide details below to improve the information on LACY DANIELLE GULLEDGE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.