Female

Audrey O. Misel PA-C

Physician Assistant in Jacksonville, FL(View on Map)

Full Name

Audrey O'Keefe Misel PA-C

NPI Number

1508271123

NPI Type

Individual Provider

Gender

Female

Enumeration Date

06/23/2014

Specialties

(Taxonomies)

Code

363A00000X
363AM0700X

Primary Taxonomy

Yes
No

Licenses

State

Florida
Pennsylvania

License Number

PA9110875
MA056991

Contact
Information

Purpose

Mailing
Location

Address

10475 CENTURION PKWY N STE 302
10475 CENTURION PKWY N STE 302

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32256-5004
32256-5004

Country

US
US

Telephone Number

(904) 398-5437
(904) 398-5437

Identifiers

Identifier

103156877

Identifier State

PA

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/11/2022

Provider Address

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