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Provider Information for 1992921977

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: 1992921977

Calendar   Last Updated:  2007-07-08
  Certification Date: 


Name Value
NPI 1992921977
Enumeration Date 2007-04-18
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 9256 BIRMINGHAM AVE
WEEKI WACHEE, FL 34613-4424
United States

Phone: 352-596-0907 | Fax: 352-597-5270
View Map External Link
Primary Practice Address 4644 KEYSVILLE AVE
SPRING HILL, FL 34608-3515
United States

Phone: 352-666-4216 | Fax: 352-666-4216
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LA2200X - Nurse Practitioner Adult Health FL 912712-ARNP