MEDICARE: WHITNEY STORM CHARISMA ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WX0003X	Inpatient Obstetric Registered Nurse	9331148	FL
2	363LF0000X	Family Nurse Practitioner	9331148	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174972301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY STORM CHARISMA ARNP

Provider Business Mailing Address
First Line	:	PO BOX 522691
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32752-2691
Country	:	US
Telephone Number	:	407-900-1394
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 LEXINGTON GREEN LN STE A
Second Line	:
City	:	SANFORD
State	:	FL
Zip	:	32771-1022
Country	:	US
Telephone Number	:	407-900-1394
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2016
Last Update Date	:	08/24/2023

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Directions to “ WHITNEY STORM CHARISMA ARNP” Practice Location

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