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Provider Information for 1861727042

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1861727042

Calendar   Last Updated:  2019-04-05
  Certification Date: 


Name Value
NPI 1861727042
Enumeration Date 2009-10-06
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 14690 SPRING HILL DR STE 101
SPRING HILL, FL 34609-8102
United States

Phone: 352-799-0046 | Fax: 352-606-2857
View Map External Link
Primary Practice Address 120 MEDICAL BLVD STE 107
SPRING HILL, FL 34609-0221
United States

Phone: 352-515-6944 | Fax: 352-616-6937
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other BCBS FL Y068H
MEDICAID FL 008051200
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LP2300X - Nurse Practitioner Primary Care FL ARNP9218508