Provider Demographics
NPI:1861976789
Name:GASAWAY, ALEISHA MICHELLE (APRN FNP)
Entity type:Individual
Prefix:MRS
First Name:ALEISHA
Middle Name:MICHELLE
Last Name:GASAWAY
Suffix:
Gender:F
Credentials:APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13927 SHIPWRECK CIR N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-1121
Mailing Address - Country:US
Mailing Address - Phone:904-710-9719
Mailing Address - Fax:
Practice Address - Street 1:3847 CHASING FALLS RD
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-3570
Practice Address - Country:US
Practice Address - Phone:662-213-2648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily