Provider Demographics
NPI:1639793094
Name:SAUNDERS, MACY E (APRN)
Entity type:Individual
Prefix:
First Name:MACY
Middle Name:E
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MACY
Other - Middle Name:E
Other - Last Name:SELVIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11112 SAN JOSE BLVD STE 22
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-7952
Mailing Address - Country:US
Mailing Address - Phone:904-379-5052
Mailing Address - Fax:904-337-1623
Practice Address - Street 1:11112 SAN JOSE BLVD STE 22
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-7952
Practice Address - Country:US
Practice Address - Phone:904-379-5052
Practice Address - Fax:904-337-1623
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007201363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health