NPI 1124526025 · live from the CMS NPI Registry
Tanisha Anderson, DNP, APRN, FNP-c
Nurse Practitioner, Family in Jacksonville, FL. National Provider Identifier 1124526025, active.
NPI record
| NPI | 1124526025 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 12412 San Jose Blvd Ste 402, Jacksonville, FL 32223 |
| Practice phone | 904-638-3511 |
| Mailing address | 7643 Gate Pkwy Ste 104-523, Jacksonville, FL 32256 |
| Enumerated | January 25, 2018 |
| Last updated | October 19, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Family primary | 363LF0000X | APRN9297657 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.